Risk Adjustment

COVID-19 Brings Telehealth to the Forefront

Written By
Erik Simonsen
Chief Operating Officer

In a bid to contain the novel coronavirus (COVID-19), President Trump declared a national emergency on March 13, unlocking $50 billion in aid and expanding Medicare telehealth benefits. Aimed at providing Medicare beneficiaries greater access to healthcare services, the move will help members receive safe, continual care while limiting exposure and spread of the virus.

Under the 1135 Waiver Authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Centers for Medicare & Medicaid Services (CMS) will temporarily pay for a wide range of telehealth services at the same rate as in-person services. Prior to this emergency action, telehealth services were only allowed for routine visits in certain circumstances. As of March 6, Medicare will now cover services such as preventive health screenings and mental health counseling.

Beyond helping contain the spread of COVID-19, telehealth will play a key role in continuing patient care and provider outreach. In many cases, in-home and annual wellness visits have been halted. Health plans will see a huge gap in collecting diagnosis codes and performing critical member tests and labs which impact HEDIS ratings. If no action is taken, such a disruption could potentially imperil the ability to care for members and Medicare Advantage reimbursement. By replacing these in-home assessments with telehealth visits, health plans can effectively mitigate the downstream consequences.


The Evolution of Telehealth


While the spotlight on telehealth may be new, the technology itself is not. In fact, NASA leveraged it in 1969 to remotely monitor the health of astronauts landing on the moon. In 2016, the Health Resources & Services Administration (HRSA) signaled its commitment to the technology with a $16 million investment. Over the past few years, adoption has begun to accelerate across a wide-range of use cases, including an extensive effort to curb a flu outbreak earlier this year. With the unprecedented spread of the coronavirus, telehealth will take a much more prominent role in the future of healthcare.

Telehealth’s appeal comes from its simplicity. In an era where many technological “solutions” can be difficult to navigate, telehealth is uniquely easy to use. By pushing a button on their smartphone or computer screen, patients can access providers without having to make a physical visit to a doctor or hospital. People today expect user-friendly products that truly make their lives easier—and healthcare is no different.


Telehealth & the Future of Healthcare


At its core, telehealth is a force multiplier that can safely extend the reach of healthcare workers on an exponential level. The emergency aid and expansion of Medicare telehealth benefits presents a case study for the technology’s broad use. Provider groups and payers can test the available systems for screenings and check-ups while keeping physicians and patients at a socially responsible distance. The support is in place, the precautions are necessary, and the outcomes are still reliant on doctor-patient interaction.

As an extension to our In-home Healthcare services, Episource has launched an easy-to-use telehealth solution. This technology connects providers with members to ensure a thorough health assessment is completed.

To learn more about the updated CMS telehealth guidance for MA during COVID-19 Emergency, here is a list of helpful resources:



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