As 2024 draws to a close, the impending expiration of telehealth flexibilities looms, potentially reversing transformative changes made during the COVID-19 pandemic. These adjustments significantly expanded telehealth capabilities, especially within the Medicare system, and their lapse could result in a “telehealth cliff.”
Changes in Telehealth Flexibilities
Expanded Definition of “Originating Site”
One of the most significant changes during the pandemic was the expanded definition of “originating site” for telehealth services. This expansion meant that any location within the United States, including patients’ homes, could be considered an originating site. This change dramatically increased patient access to telehealth services, particularly for those who faced challenges traveling to healthcare facilities. Individuals living in rural areas or those with mobility issues greatly benefited from the convenience of receiving care from their homes.
Alongside this, Medicare also began allowing a wider range of services to be delivered via telehealth. New provisions included allowing physical therapy, certain emergency services, and other essential healthcare functions to be conducted remotely. This flexibility meant more comprehensive care could be provided without requiring in-person visits, thus maintaining continuity of care for many patients who depend on these services. The varied applications of these allowances spotlight how integral telehealth has become in ensuring healthcare accessibility.
Inclusion of Various Service Providers
Another pivotal change was the inclusion of a broader range of service providers allowed to offer telehealth services. Prior to the pandemic, only physicians and a select few other practitioners could bill for telehealth sessions under Medicare. However, the flexibilities expanded this list to include occupational therapists, physical therapists, speech-language pathologists, and audiologists. This broadening of approved providers reflected an understanding that comprehensive healthcare goes beyond just medical doctors and requires input from a diverse array of health professionals.
Another important aspect was the removal of the in-person requirement for behavioral health services. Previously, Medicare rules required at least one in-person visit every 12 months for beneficiaries receiving mental health services. This requirement was lifted, enabling patients to receive necessary and consistent mental health care without the potential barriers posed by in-person visits. These changes were instrumental during the pandemic, reflecting a more inclusive approach to healthcare delivery. However, with the expiration date looming, many fear that returning to pre-pandemic norms could hinder access to vital services.
Legislative Actions and Implications
The Role of Congressional Action
The overarching trend during the pandemic highlighted the need for greater flexibility in telehealth provisions, demonstrated by the increased accessibility and convenience for patients. However, these expansions hinge on legislative action to become permanent. Despite various proposed bills aiming to extend these telehealth flexibilities, none have progressed to the voting stage. The Centers for Medicare & Medicaid Services (CMS) acknowledged the looming “telehealth cliff” in their Provider Fee Schedule for 2025 but noted their limited authority to extend these provisions independently. The responsibility lies with Congress to enact new laws to prevent a rollback to pre-COVID-19 regulations.
The failure to enact such legislation could severely restrict patient access to care, particularly for Medicare beneficiaries. This uncertainty creates challenges for both patients and healthcare providers, who now need to stay abreast of legislative developments. Effective planning and adaptation are essential to prepare for the possible reduction in telehealth services. Organizations and providers must strategize to ensure they can continue offering quality care, whether through advocating for policy changes or adjusting their service delivery in anticipation of restrictions.
Preparations and Future Outlook
Healthcare providers must remain vigilant and proactive as 2024 draws to a close. Without new laws to safeguard current flexibilities, the expiration of telehealth provisions could significantly reduce Medicare patients’ access to necessary services. Providers must monitor legislative activities closely and prepare for various outcomes to mitigate disruptions. Preparation might involve optimizing in-person care protocols or seeking alternative funding to support continued telehealth services under potentially restrictive regulations.
As the deadline approaches, organizations may also benefit from collaborating with policymakers, offering insights and empirical data to support the case for extending telehealth flexibilities. This collaborative approach can help highlight the crucial role of telehealth in modern healthcare delivery and emphasize the potential consequences of reverting to pre-pandemic norms. The coming months will be critical in shaping the future of telehealth and maintaining the strides made during the pandemic in enhancing patient care and accessibility.
Conclusion
As 2024 comes to a close, the expiration date for temporary telehealth flexibilities looms on the horizon, threatening to undo the significant changes brought on during the COVID-19 pandemic. During the health crisis, telehealth services dramatically expanded, particularly within the Medicare system, making remote healthcare more accessible and convenient for millions. This adaptability proved crucial, allowing patients to receive medical care without the risk of in-person visits. However, with the potential expiration of these flexibilities, there is growing concern about falling off the so-called “telehealth cliff.” Such a development could result in reduced access to virtual care, especially for those dependent on Medicare, thereby reversing much of the progress made in reshaping healthcare delivery. Policymakers must now decide whether to extend these telehealth provisions or risk reverting to a pre-pandemic model that lacks the benefits and accessibility of current telehealth services. The impending decision will undoubtedly have a profound impact on the future of healthcare in America.
