Covid-19 Stimulus Package
- Christopher Leonard, DO, MHI
- April 2, 2020
The $2.2 trillion stimulus package President Trump signed in late March will provide a major boost to healthcare, allowing even more patients to access care through Telehealth. Using Telehealth is particularly vital during the spread of the coronavirus pandemic as it keeps patients out of clinics and limits exposure for health care workers.
Americans now have access to their providers via telehealth services to ask questions, raise coronavirus concerns, and address diabetes or psychotherapy needs – and the like – from home through calls with providers on platforms like Zoom, FaceTime, or standard phone calls.
Patients can also use a Telehealth service such as that provided by Vohra Wound Physicians to maintain continuity of care for many conditions, including in home health scenarios. With this service, nurses together with patients in one place of care, can communicate with specialists remotely to maintain specialist involvement. For example, in skilled nursing facilities, a wound care nurse may communicate via telemedicine with a wound care specialist to continue to diagnose, consult and treat chronic wounds.
Before the COVID-19 crisis, only 9% of Americans reported using Telehealth. But now, online Telehealth companies are reporting increases of 200 – 1,000% in use. With the passage of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the use of Telehealth is expected to rise even more.
The American Telemedicine Association (ATA) has praised the stimulus package, saying the bill recognizes that expanding virtual care is necessary to defeat COVID-19.
“We commend Congress for recognizing the power of telehealth, and the bipartisan effort to lift telehealth barriers in the Medicare program while prioritizing federal funding for telehealth access and infrastructure during this emergency,” said Ann Mond Johnson, CEO of ATA.
Essentially, the CARES Act makes it easier for people to use Telehealth, details are found in Sections 4401, 4404 and 4213, some of these remove deductible requirements, expand access for Medicaid patients and relax rules regarding video and Telehealth.
How the Stimulus Package Increases Access to Telehealth
There are several ways the stimulus package helps Americans access Telehealth:
Patients with high-deductible health insurance policies can now access Telehealth without first reaching their deductible. Insurance companies must now provide full coverage for any Telehealth visits (Section 4401 of the CARES Act).
The bill slashes video requirements for using Telehealth in Section 4213, meaning patients can now just use the phone to reach health care providers.
The COVID-19 Medicare telehealth waiver requirement mandating that a provider must have an existing relationship and had seen the patient within the last 3 years is now gone, as is presented in Section 4404.
The bill provides $200 million for the Federal Communications Commission (FCC) to support the efforts of health care providers to address coronavirus by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services.
$180 million for the Health Resources and Services Administration to carry out telehealth and rural health activities.
This bill goes even further than the Centers for Medicare and Medicaid Services’ new Medicaid waiver, which went into effect early March. Waiver 1135 broadened access to Telehealth by instructing Medicare to pay for more online visits, including from doctors, nurse practitioners, clinical psychologists and licensed social workers.
The stimulus package will work in tandem with the waiver to offer Telemedicine services to a larger group of people during the COVID-19 pandemic.
Telehealth’s Role in Reducing the Transmission of COVID-19
The coronavirus is shown to be most aggressive amongst older people, with 8 out of 10 deaths attributed to people aged 65 and older. It is important to limit exposure for our most vulnerable populations and to keep COVID-19 out of skilled nursing facilities.
The best way to do this is for elderly patients to use Telemedicine for basic questions and concerns, as well as for treatment of chronic problems like chronic wound care. Plus, vulnerable patients can use Telehealth if they think they might have the coronavirus. They can talk to their provider via video to address next steps and treatment options without risking infection during an in-person visit.
With 80% of Americans now under stay-at-home orders, Telehealth is a great way for people to access doctors and clinicians in the comfort of their own home.
How Clinics Can Start using Telehealth to Treat Patients
Now that more Americans can access Telemedicine, it is up to clinics and hospitals to implement programs to offer these virtual services. The American Medical Association developed a quick-start guide to help clinics get onboard.
First, it is important to put a team in charge of implementing telehealth, and then check with malpractice insurance to make sure telemedicine services are covered. Finally, clinics must familiarize themselves with payment and policy guidelines for each telehealth service. After those initial steps are taken, a hospital can select a vendor, organize patient workflow and set up a way to document and track Telehealth visits.
The American College of Physicians also has a free and informative online course to help doctors set up Telemedicine services. This course goes over which medical services are best offered online, use cases for Telemedicine and detailed guidance for selecting and implementing a system of delivery.
Providers Rush to Meet the New Demand for Telehealth
As Telemedicine is crucial to combatting the novel coronavirus, providers are stepping up to meet the increased demand. Amwell, which offers telemedicine services, reported an increase of 257%, with increases closer to 700% in hard-hit states like Washington.
Hospitals and clinics are rushing to hire new doctors and build robust telemedicine platforms. The FCC has detailed a plan for the $200 million allocated by the CARES Act to help hospitals beef up broadband connectivity and devices to expand Telehealth services.
Vohra Wound Physicians, which has operated a telemedicine platform for over seven years, recently announced increased access to Telemedicine for chronic wound care. The service allows Vohra’s wound care specialists to continue monitoring, evaluating and directing treatment for our most vulnerable patients in skilled nursing facilities while protecting both patients and the clinicians themselves against COVID-19.
It is Imperative for Hospitals to have a Robust Telemedicine Infrastructure in Place
As more and more Americans access Telemedicine for everything from psychological visits to flu symptoms to wound care, it is important for hospitals and providers to meet the demand. Using Telehealth is one major way to slow the spread of coronavirus and stem deaths amongst older and vulnerable populations.