The COVID-19 pandemic has affected almost every aspect of our world, from our personal lives, to the jobs of millions – even health care. The pandemic did not change our need to go to the doctor, especially for people with chronic conditions like psoriatic disease. Telehealth services have been one way to ensure continuity of care, allowing patients to access health care right from their homes.
As lawmakers consider policies to maintain expanded access to telehealth post-pandemic, the National Psoriasis Foundation (NPF) is listening to your experiences with telehealth to make sure our community is heard.
Expanded Telehealth During COVID-19
While telehealth services have been available in a limited way to some for the past few years, access is often restricted by requirements patients have to follow. Take Medicare for example. For a telehealth appointment, a Medicare beneficiary would have to travel to an approved medical facility (known as an originating site) and use a specific teleconferencing system to access their provider. There were also strict guidelines limiting what types of health care providers could be accessed using telehealth services.
During this COVID-19 public health emergency, federal and state agencies have provided temporary flexibilities for telehealth to ensure all patients have access to health care, such as allowing patients to hold their appointments from home on a personal laptop or cell phone. Many of these flexibilities will expire when the public health emergency period ends.
Health care providers have had to adapt quickly to be able to offer telehealth services. Many did not previously offer those types of appointments, so this included new investments in technology and training for themselves and their staff, in order to meet patient needs during the pandemic. While investments have been made to make telehealth more accessible to patients, there have been complications for providers with reimbursement for these services. Reimbursement for telehealth varies between health insurance carriers and often depends on what type of insurance plan a patient is enrolled in.
Legislators and the Administration are beginning to look forward to what the world will look like post-pandemic, and making expanded access to telehealth permanent is at the top of many lists. Recently, the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said, “I think the genie’s out of the bottle on this one [telehealth]. I think it's fair to say that the advent of telehealth has been just completely accelerated, that it has taken this crisis to push us to a new frontier, but there's absolutely no going back.” Several bills have been introduced in Congress and the Administration has included telehealth provisions in a recent executive order and in regulatory proposed rules.
It is not only the federal government acting. States are considering policies to expand telehealth networks through legislation or regulatory action. In Colorado, a recently enacted bill expands the definition of telehealth to include mental health services. The bill, SB 20-215, also allows for flexibility around what technology can be used for telehealth. This is one of many pieces of legislation NPF's advocacy team is tracking.
Representing the Patient Voice
As these efforts gain momentum, NPF is working to ensure the patient perspective remains a leading voice in the process.
Recently, NPF began leading a telehealth working group, comprised of a diverse set of patient advocacy organizations, to examine what telehealth flexibilities have worked best for patients and should become permanent once the public health emergency has ended.
We have also been asking our Advocacy Action Network members about their experiences with telehealth during the pandemic. Overall, feedback has been positive about telehealth services, but patients have acknowledged challenges for certain types of care. For telehealth appointments with a dermatologist or rheumatologist, some patients have expressed difficultly in showing an outbreak area on camera depending on its location or having a joint inspected through telehealth. Providers have also expressed a concern that for certain appointments being able to physically touch and feel a joint is important, and it isn’t something that can be done through a computer or on the phone.
While telehealth is a vital tool for patients and providers, it cannot replace all in-person care. As we move forward to what the future of telehealth looks like, it is imperative that the patient voice is considered, empowering you to choose whether a telehealth or in-person appointment best meets your health care needs.