Q&A: How the end of PHE could affect telemedicine and patient care

A public health emergency declared at the beginning of 2020 was introduced to ensure Waivers from Centers for Medicare and Medicaid Services to ease the strain on hospitals and other providers during the pandemic. It has been extended 12 times since its implementation and is finally due to end on May 11th.

Heather Meade, director of the Washington Council Ernst & Young, spoke with MobiHealthNews about how the end of PHE could impact telehealth companies’ funding streams and patients’ access to care.

MobiHealthNews: What are the advantages and disadvantages of discontinuing PHE, especially for telemedicine?

Mid: That is, we need a permanent policy in these areas. On a national level, it’s kind of a ray of hope, right? When I hear Congressional leaders on the hill talk about the things they want to keep as a result of the pandemic, telemedicine is always on that list. And I think that really gives Congress the opportunity to have a real discussion about the potential to sustain telehealth on an ongoing basis and what it should look like. And I think it’s always good for us to have a healthy public debate on these issues.

The learning curve for politicians can sometimes be quite steep, and it is difficult, especially in this bipartisan and budget-constrained environment, to do all the things that everyone would like to do. But I hope there is enough public pressure and public recognition of the benefits of telehealth to really move this policy forward, or at least create some long-term extensions so that providers can continue to invest in the technology and we can continue to grow.

MHN: How will the end of the PHE affect funding flows?

Mid: It depends. It’s very software. For telehealth, many funding streams will not be affected because we have a temporary extension until 2024 for Medicare reimbursement. Some states have already begun to limit the flexibilities they provide. In particular, some states have allowed ISPs to do several things. One of them is to charge facilities when you know they receive telehealth care as if they were there. Some of these parts have been pushed back.

Some states required telemedicine is paid at parity. This is probably the biggest issue, and it was really important, especially for hospitals that were getting reimbursed for telehealth, as if they were treating that person in the hospital or at the provider’s office.

So as states take this away from Medicaid patients and the federal government has the ability to renegotiate the appropriate level of reimbursement, it does pose quite a significant risk to the flow of funding in government-paid markets. And it’s very likely that the government won’t say, “You should get 100 percent parity under all circumstances.”

So we can see how Congress thinks about it, some potential differences, both in the type of assistance provided, where the assistance is provided, and the program under which it is provided. We’re going to start seeing more variations around this.

MHN: How will the end of the public health emergency affect patients in general?

Mid: I think there are two effects. First, if the hospitals and provider groups where this is happening feel they are lacking support, will they give up their willingness to invest, participate and provide it?

Patients love it. We’ve seen a huge surge in usage [during the height of the pandemic], and we’re seeing a pretty significant decline in usage compared to 2022. But it is still three times what it was before the pandemic. So it’s still very important. I think the only question is, will there still be sufficient funds invested in it? I think there is patient interest and demand.

Many of these articles will differ depending on where they got their coverage, what opportunities they used. For example, there is a provision that allows telemedicine to be offered as a separate product. And so an employer can offer it to their part-time employees who are not enrolled in insurance coverage, and this provision has not been expanded. So, if you are that person, this can be a pretty immediate change, right? But if you’re on Medicare, you might not notice such a big change because you have a two-year extension from Congress.