Payer and provider organizations across the country urged CMS to include audio-only visits in Medicare Advantage risk-adjustment policies. In a letter to Congressional members, the leading trade groups led by America’s Health Insurance Plans (AHIP) expressed support for legislative action in this area.
- Support of the new legislation: Prominent healthcare organizations have announced their support of new legislation that would allow for audio-only telehealth services to apply toward Medicare Advantage (MA) risk adjustment. AHIP President and CEO Matt Eyles released a statement in support of the Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 introduced by Rep. Terri Sewell (D-AL) and Rep. Gus Bilirakis (R-FL).
- An approach to bridge gaps: Eyles noted that telehealth has bridged care delivery gaps amidst the COVID-19 pandemic, allowing those who are at high risk of infection, such as seniors, to receive care in the comfort and safety of their own homes. However, he noted that current MA policies which limit telehealth reimbursement to audio-video calls are not considering those beneficiaries who may not have internet access.
- The reason put in: “Many seniors in rural and urban communities still struggle with a lack of broadband internet services. Lawmakers have recognized the importance of telehealth and this important legislation recognizes that for many seniors, a phone call is their only option for health care at home,” Eyles wrote. “AHIP recently joined with 10 other healthcare organizations in support of the bill, which would help ensure that seniors have access to the high-value telehealth benefits provided by the MA program, and reduce health disparities caused by unequal access to technology,” he continued.
- Barriers revealed: Research from Better Medicare Alliance, which also signed onto the letter, revealed barriers to audio-video telehealth for many beneficiaries. Specifically, 34 percent of MA enrollees who live under the federal poverty level, and 33 reported no internet usage at all, the data, out of the group’s Center for Innovation in Medicare Advantage, showed. Additionally, 33 percent of MA beneficiaries over age 85 reported no internet usage.
- Accessible care: “The Ensuring Parity in Medicare Advantage and PACE for Audio-Only Telehealth Act is a sensible, bipartisan, and sorely needed solution that will protect our most vulnerable Medicare Advantage beneficiaries’ ability to access the care they need during this public health crisis. Medicare Advantage must be equipped to meet beneficiaries where they are by allowing access to care through a simple phone call where appropriate or when beneficiaries lack other technological means,” President and CEO of the Better Medicare Alliance Allyson Y. Schwartz said.