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TELEMEDICINE

For a physician practice, the demand for services may exist; how-
ever, much of the public is frightened to visit a doctor's office out
of fear they may become infected with COVID-19. Therefore, the
demand is reduced. Furthermore, the supply (i.e., healthcare
providers, including MAs, NPs, PAs, and doctors, as well as the back
office to manage the demand) is diminished for many practices.
Whether shutting down businesses is an effective strategy to miti-
gate COVID-19 remains to be seen.
How can a physician mitigate the lower demand for services dur-
ing this pandemic? Telemedicine is one way for patients to seek
medical advice while at their home. And conversely, not having a
patient come into the office helps the physician manage their supply
and capacity issues at a physical location. Telemedicine is not a
panacea by any stretch; however, it can help mitigate some of the
issues mentioned supra. Patients can seek needed advice, and the
physician can decide who should be involved in managing a patient's
medical concern (i.e., the triage approach).
Prior to COVID-19, physicians were reluctant to adopt Telemed-
icine for a variety of reasons. Two of the biggest reasons had to do The Telemedicine services a physician can provide under the Pub-
with compliance with the Federal Government and the payment as- lic Health Emergency (PHE) section 1135 waiver is quite extensive.
sociated with such visits. CMS has relaxed the rules and Texas has All services that a covered health care provider, in their professional
also followed suit. The Texas Medical Association (TMA) surveyed judgment, believe that can be provided through Telehealth in the
Texas doctors and asked them in April 2020 if they would use given circumstances of the current emergency are covered. This in-
Telemedicine. 80% indicated they would. cludes diagnosis or treatment of COVID-19 related conditions,
Payment parity is a very important issue for physicians. Many such as taking a patient's temperature or other vitals remotely, and
physicians believe that as long as a contracted physician performs a diagnosis or treatment of non-COVID-19 related conditions, such
covered service that meets the standard of care for a particular as a review of physical therapy practices, mental health counseling,
episode of care, then what a Managed Care Organization (MCO) or adjustment of prescriptions, among many other services.
pays for such service shouldn't be conditioned on the location, As more physicians and patients adopt Telehealth platforms, it is
meaning office, video, or telephonic visit. The good news is that likely that Telehealth will remain a terrific alternative to an in-person
CMS has created payment parity. Medicare pays the same amount office visit for many patients. This is particularly true for patients
for Telehealth services as it would if the service were furnished in that have a long drive to a physician's office. Adopting new tech-
person. Not all MCOs have adopted payment parity; thus, physi- nologies to meet the demand of existing patient services is a terrific
cians should seek advice when seeing a non-Medicare or Medicaid way to accommodate the marketplace. Additionally, many patients
patient. would rather have a video conference in the comfort of their home
as opposed to driving to a doctor's office waiting for their name to
The Health Resources and Services Administration be called. Not that Amazon is a fair comparison per se; however,
(HRSA) of the U.S. Department of Health and Human creating a great customer experience at the convenience of the pa-
tient will create an ongoing demand for physician services via
Services (HHS) define Telehealth as the use of electronic
Telemedicine. The world is changing, and organizations must de-
information and telecommunications technologies to sup-
cide whether they will and can adapt to the changing environment
port and promote long-distance clinical health care, pa-
or potentially face bankruptcy for failing to innovate.
tient and professional health-related education, and
public health and health administration. Technologies in- Alan Preston works in the area of Population Health Manage-
clude videoconferencing, the internet, imaging, streaming ment and has a doctorate in Science in Epidemiology and Biostatis-
media, and landline and wireless communications. tics from Tulane University and has spent his entire career in the
healthcare space.
visit us at www.bcms.org 15