Recently, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 was reintroduced by Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.), along with Senators Johnny Isakson (R-Ga.), and Mark Warner (D-Va.), co-chairs of the Finance Committee Chronic Care Working Group. The first version of the CHRONIC Care Act was rejected after being introduced in Congress in December 2016. Reintroducing the bill is part of the sponsors' efforts to develop policies that will improve the quality of care without adding to the federal deficit according to Sen. Hatch in a statement.
The CHRONIC Care Act is the second bill introduced recently that intends to expand Medicare coverage of telehealth. The Telehealth Innovation and Improvement Act, introduced previously, would allow hospitals to test providing telehealth services to Medicare beneficiaries.
The Chronic Care Act bill (S. 870) contains significant telehealth provisions for patients suffering with chronic conditions. In addition to expanding Medicare Advantage coverage of telemedicine for all patients, the bill would also expand coverage of telehealth for specific groups of patients: stroke patients and recipients of dialysis at home, who would be able to have their monthly clinical assessments performed via telehealth without geographic restrictions.
Title III of the bill specifically addresses the expanded use of technology for the use of telehealth in the care of patients with chronic conditions. Section 303 of the bill would also allow a Medicare Advantage plan to offer additional telehealth benefits in its annual bid amount beyond the services that currently receive payment under Part B, beginning in 2020. “An MA plan may provide basic telehealth benefits as part of the standard benefit; for example, telemonitoring and web-based and phone technologies can be used to provide telehealth services,” states the bill.
“Medicare Advantage Prescription Drug (MAPD) Plans may choose to include telehealth services as part of their plan benefits, for instance, in providing medication therapy management (MTM). However, while there is nothing to preclude MA from providing telemedicine or other technologies that they believe promote efficiencies beyond what is covered in the traditional Medicare program, those services and technologies are not separately paid for by Medicare and plans must use their rebate dollars to pay for those services as a supplemental benefit.”
In addition, under Section 304, certain accountable care organizations would be given more flexibility to provide telehealth services. This section would apply the Next Generation ACO telehealth waiver criterion to the Medicare Shared Savings Program (MSSP) Track II (only if an ACO chooses prospective attribution and remains at two-sided risk), MSSP Track III, and the Pioneer ACO program. This provision would (1) eliminate the geographic component of the originating site requirement, (2) allow beneficiaries assigned to the approved MSSP and ACO programs to receive currently allowable telehealth services in the home, and (3) ensure that MSSP and ACO providers are only allowed to furnish telehealth services as currently specified under Medicare’s physician fee schedule, with limited exceptions.
So, what does this mean for providers considering the use of Telehealth? There is an overall commitment from the governmental as well as other payers to expand access to care through technology. The nuances of reimbursement will continue to be explored and refined, but the use of telehealth is now a given, especially as healthcare continues to move from a fee for service, volume-based model of care to one focusing on improving clinical outcomes at a lower cost per patient (value-based care). Technology is a critical component of this expansion of value-based care.
At Corstrata, we focus on measureable clinical and financial outcomes as we partner with healthcare organizations including home health agencies, hospices and skilled nursing facilities to provide access to wound experts via telehealth, mobile health, and video technologies. Our previous experience taught us that in addition to providing our clients and their staff with the Corstrata mobile app, we must also assist clients in hardwiring virtual wound management into their processes resulting in better wound care at a lower cost.
Corstrata utilizes mobile technologies to create access to our board-certified wound care specialists to produce a return on investment for our customers. Corstrata assists providers in the proper assessment of wounds during the completion of the provider specific patient assessment- MDS, OASIS C2, etc. Additionally, we collaborate with providers to develop a wound program that includes evidence-based, best practice wound treatments, staff education, pressure ulcer prevention program, and wound formulary redesign. Corstrata’s wound image and video consults provide accurate identification of the wound type and associated staging, precise wound measurement, and the recommended best practice treatment and wound dressing to improve clinical and financial outcomes.
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