What's Your Telehealth Plan?
COVID-19 is pushing U.S. healthcare to adopt practices it should have integrated years ago, and telehealth is at the top of the list.
- By David Kopf
- May 19, 2020
I’ve been thinking a good deal
about what post-acute healthcare, and particularly
HME, will look now that COVID-19 has become
a global reality. We’ve seen a lot of rapid change
in terms of Medicare policy relaxations (read our
cover story, starting on page 6, for more about
that) to help providers work with patients and
referral partners under these circumstances. And
now we’re all wondering, which policy changes are
temporary and which will remain?
The one broad policy change that I’m certain
will remain is telehealth. Here in HME, we’ve seen
an elimination of the three-year established patient
relationship requirement from telehealth provisions
and the removal of the face-to-face exam
requirement for items that otherwise require them
due to NCD or LCD.
We’ve also seen CMS waive any limitations on
the types of clinical practitioners that can furnish
Medicare telehealth services. Now CMS’s telehealth
list to include both two key clinical partners/staff
for HME providers: Physical Therapists (PTs) and
Occupational Therapists (OTs).
And when it comes to referral partners, similar
policy changes have made it much easier for physicians
to confer and consult with their patients
via telehealth, rather than in person, to minimize
contact. Now, doctors are just as likely to meet
with patients on their laptop as they are in their
It’s important to remember one overriding factor:
telehealth makes sense. Let me give you a personal
example. Recently I had a six-month follow-up
slated for a specialist to see how I’m doing. (It was
no big thing, but the doctor wanted to be thorough.)
Normally, that appointment wouldn’t have
been a problem; I would have driven about 15
minutes from our offices to the doctor’s office for
However, with California’s stay-at-home guidelines
still very much in effect, I wouldn’t have
driven from the office; I would have driven from
home. Even with Southern California’s radically
diminished traffic, I’d still face at least an hour’s
worth of driving. Also, I’d be sitting in a waiting
room with other patients and interacting with staff
that have been engaging a wide swath of people
during a disease outbreak. The entire scenario
wasn’t exactly ideal.
So I asked if telehealth was an option. The office
manager replied, “of course!” Within a couple of
hours I was in a Zoom video conference, getting a
follow-up Q&A and consultation from the physician.
No muss, no fuss, and no time-wasting back-and-forth drive.
The whole arrangement made too much sense
to ignore. The appointment didn’t require physical
examination; it was simply some follow-up. So
why mess with all the other complications that
absolutely no one wants? Once patients, physicians
and other players in the care continuum get
exposed to how much easier and efficient that kind
of appointment is, why would they ever go back to
the old model?
The same goes for HME. Telehealth is radically
reducing the amount of costly truck rolling and
in-person consultation that providers and patients
otherwise need to do. Just think of a scenario
where a physician prescribes an item, recommends
a provider, the patient contacts that provider via
telehealth, the HME does an assessment, selects
and ships the needed items, and then conducts
guided set-up over the phone.
Well, that’s the reality now. For example, I spoke
with Gary Sheehan, president and CEO of Cape
Medical Supply and newly appointed CEO of Spiro
Health, and Joe Candiano, director of operations
for Hampton Homecare Inc., for the HME Business
Podcast (episodes 27 and 32, respectively). Both
rapidly rolled out telehealth for sleep patients.
(Hampton even has a name for the service:
TelePAP.) These providers see both the potential for
telehealth to improve their businesses’ cost structure
and efficiency, and recognize that there will be
patient and referral demand for that capacity.
In many respects, COVID-19 is a grim,
awful reality (as I write this, more than 85,000
Americans have perished). Still, if there is one
silver lining that we can take from this experience,
it will be streamlined, more efficient care through
innovations such as telehealth.
This article originally appeared in the May/June 2020 issue of HME Business.
David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.