President Trump has issued an executive order that permanently expands telehealth services put in place during the pandemic. The move is part of a commitment to support Medicare beneficiaries, particularly in rural communities, the White House announced Monday. 

The Centers for Medicare & Medicaid Services is also supporting a permanent expansion, and has issued a proposed rule mirroring the White House’s order. But Congress will need to approve any telehealth coverage extensions that go beyond helping patients in rural areas. This includes coverage of some doctor visits without a qualifying in-person consultation and broadened access to physical, occupational and speech language pathology services, McKnight’s has reported.

Meanwhile, telehealth use has exploded. From mid-March through early July, more than 10 million beneficiaries received telehealth services. That’s compared with 14,000 per week prior to the public health emergency, according to CMS Administrator Seema Verma.

The increased popularity of remote healthcare services may be driven as much by pandemic-era patient anxiety as it is by the new coverage. About 43% of respondents to a recent survey by DocASAP, a patient access platform provider, said that they wouldn’t feel comfortable visiting a healthcare provider in person until at least the fall. 

Yet despite all of the attention directed to telehealth use, many Medicare beneficiaries may still be unable to access it, according to new research. More than a quarter don’t have a computer with high-speed internet access or a smartphone with a wireless data plan, investigators found. The lack of digital connection was higher among adults aged 85 years and older, those with low socioeconomic status, and in communities of color, they reported.

Rehab therapists express concern

Cost-saving measures proposed by CMS alongside telehealth expansions have caused concerns for rehabilitation therapists, who say the cuts affecting their services are even worse than last year’s highly criticized 8% reduction, reported McKnight’s Long-Term Care News Executive Editor James M. Berklan. 

An estimated 9% cut, plus an expected reduction of the conversion factor by more than $3 is a “double-whammy” for rehab providers, said Cynthia Morton, the executive vice president for the National Association for the Support of Long Term Care. It could be an especially tough blow while providers try to maintain access to therapy for nursing facility patients, she told Berklan.