A new bill pending in Congress could make permanent the telehealth changes that proved beneficial to physicians and patients during the COVID-19 pandemic. Additionally, a leading physician group is now backing site-neutral payment for medical services. These two topics have recently been the subject of renewed discussion due to proposals by federal policy makers.
CONNECT for Health Act in Congress
The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 has been reintroduced by a bipartisan group of 60 senators. This legislation has gained urgency as certain telehealth provisions, which were initially permitted during the pandemic, have been extended until 2024 but are set to expire thereafter. U.S. Senator, representing Hawaii and a proponent of the bill, emphasized the importance of this legislation by highlighting the widespread use and benefits of telehealth.
In his announcement, Senator expressed the need for updated laws to align with the evolving healthcare landscape and ensure that individuals across the country have improved access to healthcare professionals regardless of their geographical location. The comprehensive nature of the proposed bill aims to facilitate increased utilization of telehealth services for better patient care.
Pre-Pandemic Support
According to the senators, a significant portion of the CONNECT Act predates the pandemic, as it was initially introduced in 2016 and has already seen the implementation of certain rules. These rules have granted physicians increased flexibility in utilizing telehealth for mental health services, stroke care, and home dialysis. However, there is still a need for further provisions, such as removing geographic restrictions on telehealth services and expanding the range of originating sites to include patients’ homes. The bill also emphasizes the importance of conducting more comprehensive studies on the utilization and impact of telehealth, with the aim of enhancing its quality of care.
Senator, a cosponsor of the bill representing Mississippi, highlighted the transformative nature of telehealth in healthcare delivery. He expressed satisfaction with the growing support for permanently integrating telehealth flexibility, as it would contribute to Medicare beneficiaries receiving the high-quality healthcare they deserve. Notably, the CONNECT Act has garnered support from various physician and healthcare groups who recognize its potential benefits.
Differing Perspectives on Telehealth
On the same day as the 2023 report to Congress by the Medicare Payment Advisory Commission (MedPAC), the bill was announced. While the MedPAC report did not formally recommend a specific course of action regarding Medicare’s future approach to telehealth services, it did reiterate its stance from March 2021. The report suggested that the U.S. Centers for Medicare & Medicaid Services should resume paying lower rates for telehealth services “as soon as practicable after the PHE” (Public Health Emergency), which concluded on May 11.
However, the American College of Physicians (ACP), in response to the report, disagrees with this approach and expressed concerns about potential payment reductions for telehealth services. According to the ACP, their members are particularly worried about the negative impact that reduced reimbursement rates could have. During the COVID-19 public health emergency, telehealth services experienced a significant surge in usage, and the ACP believes that expanding the role of telehealth in healthcare delivery can lead to improved patient-physician collaboration, enhanced health outcomes, increased access to care, and reduced medical costs. The ACP argues that decreasing reimbursement for telehealth services would undermine the potential of this important method of healthcare delivery.
Diverse Perspectives on Payment Parity across Healthcare Settings
The American College of Physicians (ACP) has voiced its support for the recommendation made by the Medicare Payment Advisory Commission (MedPAC) to Congress regarding site-neutral payments for physicians in in-person healthcare. The ACP argues that there is no valid reason for patients and the Medicare program to incur higher costs for the same type of visit simply based on whether the service is provided in a hospital-owned facility or an independent physician practice. They believe that adding fees based solely on facility ownership fails to reflect the value of the services delivered.
This issue has sparked division within the healthcare community. Patients have expressed public dissatisfaction with the increased costs they face due to service pricing discrepancies based on location. In response, hospitals contend that higher reimbursement rates are necessary to cover expenses that physician offices do not incur. The American Hospital Association has raised concerns that site-neutral payment policies could further negatively impact rural hospitals, exacerbating their already challenging average negative operating margins.
Both the ACP and the American Academy of Family Physicians are part of the Alliance for Site Neutral Payment Reform. This coalition comprises various stakeholders, including patient advocates, providers, payers, and employers, who advocate for payment parity irrespective of location.
