Crain’s Health Pulse, 7/9/2020
Primary care, behavioral health providers urge measures to sustain telehealth access post-pandemic
The Community Health Care Association of New York State and the New York State Council for Community Behavioral Healthcare are calling on policymakers to make permanent telehealth measures that have been implemented during the Covid-19 crisis.
The advocacy groups say doing so will help to address health disparities and barriers to care, aid in preventing avoidable conditions as well as higher costs, and ensure the financial stability of safety-net providers.
The groups recommend that, post-pandemic, the state should continue to support a full range of telehealth modalities, including reimbursement for telephone visits and expanded Wi-Fi and cellular service in urban areas. They also urge keeping telehealth’s use at the discretion of clinicians in collaboration with clients, based on individual patient needs and capacity.
Additionally, the groups are calling on elected officials to maximize regulatory flexibility. That includes continuing to expand the list of licensed practitioners allowed to provide such care, not requiring in-person visits before remote visits, and investing in workforce training and research to establish where telehealth is most impactful. It also includes reconsidering certificate-of-need requirements and whether certain safety-net providers need separate applications for extension sites when telehealth is a significant component of their service delivery model.
Finally, the groups stress that telehealth visits should be reimbursed on par with in-person visits, and a capitated alternative payment model could eliminate the need for the state to count and pay for each different visit type and care delivery modality.
“It is important to think about how telehealth can promote integration of behavioral health and primary care, and how that’s really been important during the pandemic,” said Rose Duhan, president and CEO of the Community Health Care Association of New York State.
As New York moves ahead in its phased reopening, continued support for virtual care is critical, Duhan said.
“We think it can be really effective in managing chronic conditions,” she said. “As we go into flu season, it can also be a way to help reduce the spread of other types of contagious infections.”
Initial outcomes have proved promising, the advocacy groups say. Expanded regulatory relief and measures for telehealth have resulted in immediate improvements in access to care.
The Community Health Care Association of New York State reports that 88% of the state’s federally qualified health centers now deliver care remotely, up from just 35% in 2018. And a recent survey by the New York State Council for Community Behavioral Healthcare found that telehealth comprised 90% of visits and 86% of revenue for behavioral health providers.
Early data indicate fewer no-shows for appointments as a result of virtual care and high patient satisfaction, particularly when it comes to telephone visits, the groups said. And telehealth visits have been a financial lifeline for providers that reported staggering declines in in-person care as a result of the pandemic and tens of millions of dollars in losses a week in some cases.
“This type of innovation in health care was due,” said Lauri Cole, executive director of the New York State Council for Community Behavioral Healthcare. “Now the challenge is, how can we ensure that all the providers that want it have the means, financial and otherwise, to capitalize on it?”
Cole said that holds especially true for behavioral health providers, which already operated on slim margins and now are tending to three pandemics at once: the opioid crisis, increased rates of suicide and Covid-19.
“We need every tool at our disposal,” she said. “Telehealth doesn’t replace anything. It simply enhances the toolbox of a clinician or staff person to be able to reach out and provide service needs.”
The goal is to influence and inform decision makers to not be afraid of telehealth as the current crisis winds down, she said. — Jennifer Henderson