Remember Telemedicine? – Oswego County Business Magazine

It was all the rage during the pandemic years. Not so much now, but experts say it’s still popular for certain things

By Stefan Yablonski

According to experts, there are several factors that are causing the decline in the use of telehealth in healthcare.

One reason for this is cost: Many insurance companies do not reimburse telehealth visits at the same rate as in-person visits, which can make them less attractive to patients.

Telemedicine is not dead, however. According to local healthcare providers, it is still widely used.

“In addition to the obvious virtual visits for patients with COVID-19 that we try to avoid in waiting rooms, we are utilizing telemedicine when possible when patients cannot come into the office due to transportation or distance,” said Jessica Digby, a physician assistant at Oswego Family Physicians, affiliated with Oswego Health.

“Many hospitals, including our own, regularly consult specialists who are not employed by local hospitals.”

Hybrid care, combining both virtual and in-person care options, has become the new standard.

“We prefer to see patients in person when possible, but a virtual option helps us continue to care for patients who otherwise wouldn’t be able to,” Digby said.

Before COVID, ConnextCare, a healthcare provider with clinics throughout Oswego County, didn’t offer telehealth services — “not because we didn’t have the equipment to do it, but because it was very much payer-driven and those types of services weren’t covered,” said Tricia Peter-Clark, president and CEO of ConnextCare.

“When that changed at the beginning of the pandemic, our telehealth visits skyrocketed, particularly within our behavioral health program. By early 2021, telehealth was accounting for 70% to 80% of all of our visits each month,” she said. “Now, four years later, on average, about 50% of all counseling and psychiatry visits are still done through the virtual platform.”

It’s a really great way to keep patients connected to essential services without having to face other barriers, such as transportation, child care or taking time off work to get to the office, she added.

According to Peter-Clark, the challenge currently is reimbursement for telehealth visits.

ConnextCare only receives 1/3 of the total reimbursement when the care provider and the patient are both outside the hospital.

“This was a practice we ran for over three years during the pandemic because it worked for patients and our healthcare staff. Now, the provider or patient has to be in the office to receive our full reimbursement,” she said. “ConnextCare brought all of our psychiatric team and social workers back in-house so we would continue to receive our full reimbursement, only to still see 50% of their schedule virtually.”

The designated physical space for the behavioral health team to work within the office limits their ability to expand these services by hiring more staff, “as we do not have the office space in any of our locations to accommodate this,” she said.

The solution to this is included in the state budgets of last year and this year.

However, despite support from the Senate and the General Assembly, the proposal was not supported by the executive branch and was therefore omitted from the budget.

“There was a separate bill introduced (Community Health Center Telehealth Payment Parity A.7316 (Paulin)/S.6733 (Rivera),” she said. “This not only impacts us, but it impacts all other Section 28s in New York State.

“Unfortunately, despite the tremendous advocacy and support within the Senate and Assembly, this was not addressed before the legislative recess. So we are back to square one.

“This change would expand access to mental health care at a time when our community really needs it. Without the reimbursement to support services, we are limited in what more we can do.”

Medicare Telehealth Expanded

Recent legislation has extended many of Medicare’s telehealth flexibilities that were in place during the COVID-19 public health emergency through December 31.

Through December 31, 2024, all patients can receive telehealth, wherever they are. They do not have to be in a home location and there are no geographic restrictions. A remote location is a location where a physician or practitioner provides telehealth.

Pending deeds

The CONNECT for Health Act would permanently remove geographic restrictions on telehealth and expand origin locations to include the patient’s home and remove requirements for in-person visits for behavioral health treatments. It would also allow rural health clinics and federally qualified health centers to serve as remote sites.

The Telehealth Modernization Act would permanently remove geographic restrictions on original location, expand the types of providers allowed to provide telehealth services, and expand coverage for audio-only telehealth, among other telehealth flexibilities.

Excellus BlueCross BlueShield: “Telehealth is here to stay”

“Telehealth has been an important tool that has expanded care options for busy patients and providers with full schedules. It has made it much easier for people to access health care, particularly behavioral health supports, regardless of where they live or whether they have the transportation to access those services,” said Lisa Y. Harris, MD, senior vice president and chief medical officer at Excellus BlueCross BlueShield. The company is the largest insurer in Central New York.

“Even after the pandemic, telehealth visits have remained very high, demonstrating that telehealth is a convenient way for our members to receive healthcare.

“Telehealth is an important tool to ensure our members have access to affordable, high-quality healthcare. Telehealth is here to stay and it is a great option for care.”