By Rachel Stoll Jan 01, 2020
The coronavirus pandemic is likely to stretch our healthcare resources and our healthcare providers to their limits in the coming days and weeks.
However, one positive emerging from the crisis is that it has focused national attention on the need to create wider and more efficient access to physicians, nurses, and other healthcare professionals. Telehealth is a key tool in this effort, a fact recently recognized by the Trump administration which announced it is expanding telehealth services for Medicare beneficiaries.
Effective March 6, CMS will pay for office and hospital telehealth visits to various providers, including physicians, nurse practitioners, clinical psychologists and social workers. Telehealth visits will be reimbursed at the same rate as in-person visits and can take place in a range of settings, including nursing homes, hospital outpatient departments and the patient’s home.
Further easing the process, some federal HIPAA requirements will be relaxed, so that physicians can deliver telehealth services with their personal phones. Physicians also will have more discretion regarding patient co-pays, so that cost won’t be a barrier to care.
These are all welcome steps, as Medicare policy has restricted telehealth delivery in the past, limiting payments to services provided in rural areas and in local health care settings, rather than homes.
Expanding access to telehealth acknowledges the reality that health care providers are not distributed evenly across the U.S. The federal Health Resources and Services Administration (HRSA) now designates over 7,000 Healthcare Professional Shortage Areas (HPSAs) nationwide – about twice the number it designated 15 years ago, many of them in rural and inner city areas. Telehealth provides a means of bringing healthcare professionals who may have extra capacity to HPSAs and other areas where there is a particularly pronounced need.
In a pandemic like the one we are now experiencing, it also has the key advantage of protecting both the health professionals who provide care and the patients receiving it, as neither party comes in personal contact with the other. Some services can take place in the home, so patients don’t have to travel and potentially expose others to viruses or be exposed themselves.
In many cases, physicians, NPs, PAs and other caregivers who provide telehealth do so on a locum tenens basis. They may work locum tenens telehealth full-time in lieu of retirement, or simply choose locum tenens telehealth in early or mid-career as a preferred practice style. They also may elect to provide locum tenens telehealth on a part-time or moonlighting basis, thereby expanding access to care that might otherwise not have been available.
The net effect of telehealth is to expand the flexibility and mobility of healthcare professionals, increasing net FTEs without increasing the actual number of physicians, advanced practitioners and other clinicians in the workforce (though we need to do that, as well).
Much the same thing can be accomplished through interstate licensing compacts that would allow physicians, nurses, and advanced practice professionals to travel from one state to another without having to obtain a license in each state. Reducing barriers to care that are created by current licensing requirements is another step the Trump administration may soon take.
It is to be hoped that the coronavirus epidemic will be addressed as quickly and efficiently as possible, and that, on the other side of the crisis, we will have innovated our way to a healthcare system that is more flexible, responsive and accessible to all patients.
Rachel Stoll is Senior Vice President of Sales for Staff Care, a leading locum tenens staffing company and a division of AMN Healthcare, the largest healthcare staffing organization in the U.S. and the innovator of healthcare staffing solutions. She can be reached at Rachel.firstname.lastname@example.org.