How Is Telehealth Changing Medicaid and Medicare Health Care Delivery after the Pandemic?

During the early phases of the outbreak, millions of patients had their medical appointments and other healthcare checkups delayed or even canceled in an effort to stop the spread of the COVID-19 virus. Some of these meetings, which usually take place in person, have been done over the phone or through a video conference.

The number of people seeking advice via telehealth services skyrocketed when the epidemic was going on. Nevertheless, there are concerns over the standard of care that patients get and the accessibility of telehealth services for all individuals.

This article investigates the ways in which Medicaid and Medicare, the two health insurance programs run by the federal government, have boosted their utilization of telehealth. These programs are used by an estimated half of the population in the United States. Over 76 million low-income Americans are enrolled in Medicaid, and about 64 million seniors and people with disabilities in the United States are covered by Medicare. People of all ages and in various states of health are eligible for participation in these two federal programs taken together.

How has telehealth use changed?

Prior to the pandemic, Medicaid participants in the majority of states had the opportunity to make use of services that were provided via telemedicine. But Medicare beneficiaries did not. According to the statutes, Medicare would only pay for telehealth services in very specific situations, such as when access to in-person care was restricted because of the patient’s location. On the other hand, in the course of COVID-19, the Department of Health and Human Services (HHS), which is responsible for regulating Medicare, removed several restrictions. Even though access before COVID was different for each program, we saw a lot of growth in the use of telehealth for all of these programs.

For instance, in the month of March, variations in the number of Medicaid beneficiaries in five specific states who utilized telehealth services were noted. It was found that the number of telehealth services available in these jurisdictions had a significant increase, one that was 15 times higher than it had been before the epidemic (from 2.1 million the year prior to 32.5 million in the 12 months from March 2020 to February 2021).

On Monday, new data pertaining to Medicare was made available, which indicated that the use of telehealth services under Medicare increased by more than 53 million services, which is a tenfold increase from the approximately 5 million services that were provided during the period of April to December 2019. (during the same months in 2020). The total amount spent on telehealth over these time periods rose from $306 million to about $3.7 billion during this time period.

How equitable is access to care?

The increasing prevalence of the use of telehealth raises further problems regarding accessibility. For instance, some people may not have access to the technology necessary for video consultations with their doctors. According to the available data, millions of people in the United States still do not have access to a high-speed internet connection (broadband). Also, not everyone has the same level of knowledge when it comes to technology issues.

Also, some doctors, especially those with smaller practices, might not have the right technology to do a private and safe video visit with a patient. and safety that is posed by telehealth technologies. We are of Patients might not know that telehealth technologies could pose risks to their privacy and safety. ese potential issues.

How could the quality of care be impacted by telehealth?

When it is not possible to receive care in person, it may be beneficial to communicate with your physician through video conferencing technology or the telephone. However, there are limitations to it. It’s possible that physicians can’t diagnose illnesses, evaluate injuries, or perform physical exams over the phone. There is also the viewpoint that telemedicine might not be an appropriate treatment option for all patients. For example, there are some reservations about using telehealth to carry out well-child checkups. These reservations have been voiced. Specifically, some of the officials that we questioned stated that it may be more difficult to keep a child’s attention during a telemedicine appointment than it would be in person. During these extremely important exams, it may be more difficult to evaluate a child’s reflexes and find any problems in the child’s body. The provision of effective physical treatment through video for individuals who have suffered an injury or impairment may also prove to be difficult.

An investigation into the methodology used by the Centers for Medicare and Medicaid Services (CMS) to assess the quality of care delivered in order to guarantee that participants in Medicare and Medicaid receive the appropriate medical attention is being carried out. It has been established that the CMS does not collect, assess, or report data on the quality of telehealthcare that is delivered by Medicaid providers; thus, it has been proposed that they start doing so.

The Centers for Medicare & Medicaid Services (CMS) have voiced their concerns about the quality of Medicare’s telehealth services, including the risk of harm to patients and the administration of needless treatments (for example, genetic testing). In spite of these worries, the CMS has not taken any actions to review the quality of care, and it does not currently hold the data that is necessary for doing so.

As a result of our research, we suggested that CMS improve how it monitors and evaluates the delivery of Medicare telehealth services, especially the number of services that are delivered through audio-only connections (phone).