Policy

Medicaid, Medicare, Telehealth, and Indian Health: Understanding the Differences

Lead

Medicare and Medicaid – two important programs for paying for health care for American Indian and Alaska Native (AI/AN) people. As we near the end of the COVID-19 Public Health Emergency (PHE), it’s going to be important to understand the differences between these programs and how they may impact reimbursements for telehealth services moving forward. Understanding these differences will be important for understanding the next steps for continuing to get reimbursed and any challenges that may be encountered in that process.

Telemedicine & Telehealth: For Allied Health Professionals, Too

Dr. Elizabeth Krupinski, PhD, Janet Major-Durkel, Melanie Esher-Blair and Peggy Stein lead the  Occupational and Physical Therapy Webinar Series late last month

According to a recent study, one in five adults polled about health care during the coronavirus pandemic said that they or someone in their household delayed receiving medical care or were unable to get care, due to office closures or shutdowns.

Although the pollsters focused questions about doctor or dental appointments, providers across the board experienced disruption in their specialty areas, including Peggy Stein, OTD, OTR/L, CHT, an Occupational Therapist in Oregon.

Telehealth QA – Is it all it’s QAcked up to be?
Lead
Trudy Bearden Wed 02/16/22, 05:02

In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the fourth in the series.

Require expertise and excellence in telehealth service delivery. Expertise with telehealth requires deliberate practice which builds on or modifies existing skills, usually with the help and guidance of a coach or teacher with targeted feedback on what to improve and how to improve those skills.

Data – Your Performance Enhancer

Lead

In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the third in the series.

Recall that data can come in many forms and doesn’t have to be a report out of your electronic medical record (EHR). It can be hashmarks, start-end times, glass globs in a jar and more. I’m not kidding about glass globs. Once when I visited the Institute for Healthcare Improvement (IHI) there were two jars; one was labeled “Having a good day” the other was labeled “Having a bad day”. Each person who checked in at reception put a glob in the jar that reflected how their day was going.

The Heart of Telehealth Performance Improvement – The PDSA

Lead

In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the second in the series.

Many people are confused about plan-do-study-act (PDSA) cycles, and I am here to set everyone straight! Dr. Don Berwick has called the PDSA the heart of the Model for Improvement. However, after many years of helping health care organizations build skill around PDSAs, it seems to be a tough nut to crack, despite its being at core of why humans are such a successful species. The more PDSAs and the faster you do PDSAs, the faster your learning and progress with improvement will be. Here are a few pointers.

The Model for Telehealth Improvement
Lead
Trudy Bearden Wed 01/05/22, 05:01

How much do you love improvement science? I have been an improvement science evangelist and guru since 2007. That was the year I completed advanced training in health care improvement with Dr. Brent James at Intermountain Healthcare in Utah.

I was a practicing clinician, clinical manager, quality coordinator, practice transformation lead, IT support (and more) at a family medicine residency that was participating in the Safety Net Medical Home Initiative. Learning the power of data and the science of improvement was one of the biggest light bulb moments of my life. I often liken it to when Johnny 5 – the robot in “Short Circuit” – throws open the barn doors, seeing the outside for the first time and remarks, “Ahh – input!”. Suddenly I could ask and answer questions, using data and measurement.

Recent Telehealth and Broadband Funding and Funding Opportunities for the Southwest Region
Lead
mholcomb Wed 12/15/21, 05:12

Telehealth services depend on quality broadband network communications. Recent legislation, executive orders, and agency funding commitments and grants are set to make a significant impact in terms of expanding and improving telehealth services and broadband availability and reliability in the southwest region and nationally.

Accessibility to Telehealth

Lead

Telehealth has many benefits including reduced, or eliminated travel and wait times; decreased exposure to communicative diseases; easier access to healthcare professionals and therapeutic interventions; and greater flexibility. However, for many individuals with disabilities, Telehealth and it's associated benefits may be out of reach due to web inaccessibility. Benefits can become barriers because of websites’ inconsistent compatibility with screen readers, closed captions, magnifiers, speech to text software (used by individuals with limited dexterity), easy to understand instructions and hyperlinks (for individuals with cognitive disabilities), and alternative text formats.

Why are many clinicians NOT excited to provide care virtually?
Lead
Jan Ground Wed 10/20/21, 05:10

Does it surprise you that some clinicians are NOT all that excited to continue to provide care without being in the same room with a patient? Virtual care includes care by video, telephone, email, text/chat, remote monitoring, social media, mobile apps, artificial intelligence and more! More than a decade ago, when I implemented video visits for one region of a large healthcare organization, one-to-one training was provided to approximately 1000 physicians, Advanced Practice Nurses and Physician Assistants who provided scheduled, outpatient care - primary care, medical and surgical specialties. Each of the trainees was given a webcam. One year after training was completed, only 70 of these trained clinicians had provided care by video at least once. Note that reimbursement was not an issue for these clinicians. They were and still are salaried, with incentives based on clinical outcomes and patient satisfaction.

Maximizing Telemedicine Benefits
Lead
Elizabeth Krupinski Wed 08/04/21, 05:08

The United States and the world have seen a dramatic increase in the use of telemedicine since the inception of the COVID-19 public health emergency due in most part to stay at home restrictions for both providers and patients. Prior to this, telemedicine was used in a wide variety of clinical and related patient care applications for at least 30 years, and had been seeing steady but not exponential growth. In many cases programs were initiated quite rapidly using readily available and often low-cost equipment and tools, unless there was already an existing program and platform in place. Further, the use of telemedicine was facilitated at the state and federal levels but widespread waivers and measures being put into place to reduce barriers that were previously in place such as changes in reimbursements, requirements regarding patient and provider locations, cross-state licensure and privacy/security requirements.