As Governor Proposes Telehealth Reforms, HCA Urges Policies Supporting Home Care’s Pioneering Role

Capitol Report | January 2021

Governor Cuomo recently announced a broad set of proposals to expand access to telehealth.

The state should move boldly on telehealth, in principle, yet cautiously when it comes to safeguards for patient care quality and standards of care across practice settings that can easily overlap or become blurred in the context of virtual platforms like telehealth.

What is telehealth?

Telehealth is the use of communications technologies to provide health care from a distance. It can include remote patient visits, patient monitoring, and many other services.

Home Care Pioneers Telehealth Model

Home care providers are pioneers of the telehealth model — a role that was recognized in 2007 with the state’s adoption of a home telehealth law and Medicaid rate distinctly for home care provider telehealth services.

Research has shown that telehealth programs overseen by home care agencies have helped curb hospitalization and readmission rates, reducing costs. A 2012 study of four home telehealth programs in New York saw a 26% drop in hospital readmissions for some pneumonia cases. Another home health agency reported a 42% drop in medical costs attributable to telehealth. More recently, one rural provider in the Adirondacks reports a 60% decrease in hospital admissions thanks to its award-winning telehealth program.

These are important milestones; yet Medicaid restructuring in recent years has adversely affected access to home care provider-led telehealth. And Medicare still does not reimburse telehealth services as part of the home health benefit.

COVID-19 Ushers New Era of Telehealth

While telehealth has grown steadily in recent years across all sectors, its need and deployment were supercharged by the COVID-19 public health emergency. Home care and other providers turned to telehealth because of its ability to reduce exposure risk for patients and caregivers whenever services could feasibly be delivered remotely as an alternative or addition to in-person care.

Telehealth is also a critical tool in home care’s medical management of complex conditions, such as heart failure and diabetes. And it provides vital access to services at a time of resource scarcity and/or for patients in remote geographic regions.

HCA commends the Cuomo Administration for creating broad, though temporary, Medicaid telehealth flexibilities during the pandemic. HCA asks for your help, on behalf of New York’s elderly, to join us in calls for Congress to provide Medicare coverage of home telehealth. We urge the federal government to follow New York’s example.

Home Care Agency Deployment of Telehealth Doubles in Pandemic

Home care’s incorporation of telehealth in patient care nearly doubled in the pandemic.

An HCA survey in November found that 22% of agencies had a telehealth program before the public health emergency. Today, 46% of them do. And almost 90% of home health and hospice telehealth adopters have increased their use of telehealth due to COVID-19.

Many of these home telehealth services are unreimbursed or are only reimbursed by temporary Medicaid billing flexibilities.

Supportive Policies for Home Care

The Governor’s latest proposals are promising and HCA awaits further details to learn more.

As these reforms advance, HCA asks that home care be supported as a pillar of the telehealth structure, with flexibility, reimbursement support and insurance coverage equitable to that which the reforms provide to other settings.

We also urge safeguards in any telehealth reform package to govern quality, and, in the case of home care, to ensure that non-home care providers do not deploy telehealth in ways that conflict with or duplicate services in the home that are licensed, regulated and duly sanctioned to home care agencies.

Again, we stress: telehealth should be bold in principle but careful in terms of practitioner and patient standards of care.

If you have any questions about HCA’s position or about telehealth in the home, please contact HCA’s Director for Public Policy and Advocacy Alyssa Lovelace.