For decades now, we have been working together to advance telehealth and remove barriers to its utilization. One of our major areas of focus has been related to barriers created by outdated federal policies, most especially Medicare policy on reimbursement (or lack thereof) of telehealth. We have implored Members of Congress and federal agencies, primarily the Centers for Medicare and Medicaid Services (CMS), to see the value that we see in providing beneficiaries with patient-centered connected care.
In 2018, Congress and CMS recognized our calls to action and provided our industry with a variety of new and unique opportunities to demonstrate the value of telehealth. Perhaps the biggest opportunity created by federal policy changes lies in the Medicare Advantage (MA) program. CMS has allowed three things for the Medicare Advantage population in the coming plan years: 1) the ability to include telehealth in the base bid rather than as a supplemental benefit, 2) the ability to use telehealth providers to meet MA network adequacy standards, and 3) the ability to apply differential cost sharing for “high value providers” (meaning that plans could choose to charge beneficiaries $0 copays for telehealth providers).
These three changes represent a huge opportunity that we cannot let slip away – and the deadline to take advantage of one of them is tomorrow. This Friday, March 15, is the deadline for MA plans to apply to participate in CMS’ Value-Based Insurance Design (VBID) Model. If MA plans apply by Friday, they then have 6 weeks (until April 30) to complete their application, which can include specifying how they would include telehealth providers to meet network adequacy standards.
This is a great opportunity: we can demonstrate that telehealth providers should be a part of the health care system – that we can solve access issues around the country and get high quality care to patients when and where they need it. We know that there is a lot to be done for MA plans to submit their Plan Year 2020 bids to CMS by June, but we urge our MA plan members to take advantage of this opportunity and apply for the VBID option by Friday. We are available to help flesh out the details in the following 6 weeks allowed by CMS.
We also urge every ATA members to reach out to the MA plans they work with to encourage them to move forward on these proposals. The time is now, and we must demonstrate that we are ready to prove that telehealth services can reduce costs and improve outcomes.