Audio-only telehealth: A ‘crucial option’ during COVID-19 pandemic
CMS recently announced it would expand Medicare coverage to include a range of services through audio-only telehealth visits, one of many changes the agency made to adapt patient care amid the COVID-19 pandemic.
“Many patients are understandably fearful of the COVID-19 pandemic and have been avoiding coming into our primary care clinics.” Daniel Bow, DO, DPM, an internist at Baldwin Family Health Care in Baldwin, Michigan, told Healio Primary Care. “They have been allowing their medical issues to spiral out of control with that decreased access, which will only increase morbidity and mortality over time.”
Therefore, Bow stressed that audio-only telehealth visits are “a crucial option for my patients to prevent the worsening of their chronic health issues, as well as to reduce potentially avoidable ER visits.”
Previous coverage decisions
When CMS first announced it would expand coverage to certain audio-only telehealth visits, the decision was met with praise by professional organizations.
“The change to allow Medicare to begin paying for telephone visits is particularly important,” Robert McLean, MD, MACP, president of the ACP, said in a press release. “This will benefit the many Medicare patients who only have landline or audio-only phones. It’s critical that we continue to treat those patients while keeping them home as much as possible while we’re facing the threat of COVID-19.”
Since then, CMS has expanded phone-based services covered by Medicare and Medicaid to include behavioral health and patient education services.
CMS also increased reimbursement for these visits. Physicians were originally being reimbursed $14 to $41 per visit, but now receive about $46 to $110 per visit, approximately the same amount they would receive for an in-person visit, according to CMS.
Despite this recent step to ensure payment parity for phone-based visits, a recent survey from the Primary Care Collaborative and the Larry A. Green Center found that just 42% of primary care clinicians reported receiving payments for most of their phone-based visits.
Equal, safe access to care
Bow stressed that audio-only visits are essential in the low-income and underserved community where he practices because many elderly patients are not “tech-savvy” enough to participate in video-based telehealth visits.
In addition, he explained that many patients in his region do not have the technology that would allow for telehealth visits with audio and video, including internet access.
“That last point may seem strange but in rural counties, the internet is often not available or affordable for people,” Bow said. “And when it is available, the connection is often not reliable for a telehealth visit.”
Therefore, he said that audio-only calls allow these patients to safely connect with their physicians.
Because of the “very real prospect” that the virus could be a long-term issue in the United States, Bow said that he is “hopeful CMS will see the wisdom in maintaining this option on a more permanent basis moving forward.”