Data released this past week from the Centers for Medicare and Medicaid Services show that more than 34.5 million services were delivered via telehealth in Medicare and in the Children’s Health Insurance Program from March through June.
Although the agency notes there is always a “claims lag” between the time a service occurs and when the claim is reflected in the database, the preliminary data suggests a whopping 2,532% increase in services delivered compared to March through June 2019.
Furthermore, given that claims lag, data for recent months is likely to be adjusted upward.
WHY IT MATTERS
Telehealth rates skyrocketed following the relaxation of federal regulations around virtual care use at the start of the pandemic, and the CMS data reflects that trend. CMS reported that rates of services delivered peaked in April and began to fall in May – again, consistent with national anecdata from providers.
The preliminary data suggests that services delivered via telehealth were highest among so-called working-age adults ages 19 to 64. Across states in April, Missouri had the highest monthly rate per working-age adult beneficiary. South Carolina had the lowest.
Among children, telehealth rates also peaked in April and began to fall in May. In April, Maine had the highest monthly rate at 402 services per 1,000 child beneficiaries, and Vermont had the lowest.
And among adults older than 65, Maryland had the highest monthly rate, with South Carolina the lowest. The agency noted that because adults over 65 are dually eligible for Medicare and Medicaid, these numbers may underestimate telehealth utilization in that group.
CMS also cautioned that there is variation in how quickly states submit data, so the state-by-state variation may be a result of claims lag.
As of June 2020, said CMS, more than 91.8 million Americans were enrolled in each state’s Medicaid or CHIP for at least one day in the year.
THE LARGER TREND
The open question of telehealth’s future is one that stakeholders have been seeking to answer for months, with reimbursement a particularly thorny issue.
CMS announced this past week that it had added 11 new telehealth services to its reimbursement list, including cardiac and pulmonary rehabilitation services.
And in September, members of MedPAC, which advises Congress on issues affecting Medicare, discussed potentially different fee schedules, based on whether providers participate in alternative payment model systems.
“Allowing clinicians who participate in A-APMs more flexibility to provide telehealth services could be another incentive for more clinicians to move into these models,” said MedPAC senior analyst Ledia Tabor.
ON THE RECORD
“Medicaid patients should not be forgotten,” said CMS Administrator Seema Verma in a statement last week regarding the announcement of the snapshot and the expansion of covered telehealth services. “This revolutionary method of improving access to care is transforming healthcare delivery in America.”
Kat Jercich is senior editor of Healthcare IT News.
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.
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