The Health 202: Why Congress isn't expanding virtual health care
NOTE TO READERS: This is the second installment of a two-part series on delivering virtual care. You can read Part 1CHESTERFIELD, Mo. — Major hospital networks experimenting with virtual care insist the approach is saving them loads of money. But Congress’s official scorekeeper doesn’t necessarily agree — and that makes lawmakers wary of expanding telehealth.in Friday’s Health 202, hospital networks including Mercy in the St. Louis area and Providence St.
But it would be up to Congress to remove restrictions on the government paying for telehealth, because they’re embedded in the Social Security Act. And that’s difficult to do, because of cost.taken the position At Mercy Virtual, a virtual care-only hospital in Chesterfield, Mo., doctors and nurses provide round-the-clock monitoring and consultations for patients in 32 hospitals within the Mercy network — mostly in Missouri, Oklahoma and Arkansas — and a few outside hospitals.
Mercy launched its virtual hospital back in 2015, which staff proudly tout as the first hospital in the United States without beds. “Traditional health care has provided care in a provider-centric, facility-centric manner,” Helton said. “What we’re doing here is we’re providing that care in a very intentional, proactive manner to the patient either before they need it or right as they need it. You’re moving the focus from provider or facility truly to the individual patient, which is a really big deal.”The Congressional Telehealth Caucus is headed by Democratic Reps. Mike Thompson and Peter Welch .
“Every time you create a new fee-for-service benefit like this, you will have people who say, ‘Cool, this is the way to improve care and reduce costs,’” said Sean Cavanaugh, who directed Medicare’s payment policies at the agency during the Obama administration. “But then you also have the people who are like, ‘This is a way for me to bill Medicare for more stuff.’ ”
One way to avoid that problem would be to expand telehealth payments within special experiments conducted by CMS where participating hospitals are paid in lump sums based on the quality, not just the quantity, of services provided. Mercy Virtual participates in some of these demonstrations, which provide a pathway for Medicare to test better ways of paying providers.
“The changes that are being made are moving in the right direction,” Helton said. “The entire environment is moving towards supporting this.”AHH, OOF and OUCHAHH: House Speaker Nancy Pelosi says Democrats will roll out legislation on Tuesday focused on lowering health-care costs and protecting people with pre-existing conditions -- an effort timed to coincide with the ninth anniversary of the Affordable Care Act being signed into law.
"In November, the American people said they want aggressive action, and the legislation Democrats are unveiling on Tuesday is a giant step in that direction," said Protect Our Care Chairman Leslie Dach."It stands in stark contrast to President Trump’s ongoing war on America’s health care and his budget that cuts Medicaid and Medicare by nearly two trillion dollars and ends protections for people with pre-existing conditions by repealing the Affordable Care Act.
Peter adds. Earlier this month, Eli Lilly announced it would start to sell a generic version of Humalog at half the list price of the brand-name version. . “At the same time, some anti-vaccination advocates suggest the crackdowns violate First Amendment rights, limit alternative views and give Big Pharma an upper hand.”Mississippi Gov. Phil Bryant signs a bill that would ban most abortions once a fetal heartbeat can be detected, at the capitol in Jackson, Miss.
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