What Happens to Telehealth During a Government Shutdown?
With Congress at a standstill over passing the funding bill, the looming possibility of a government shutdown threatens to disrupt many critical services. Telehealth, a cornerstone of healthcare innovation since the COVID-19 pandemic, stands to face significant setbacks if funding stalls and policy decisions remain in limbo. Just yesterday, the spending bill including several key extensions for telehealth and hospital-at-home was released, and today those lifelines could use some serious lifeboats.
Here’s a closer look at what this means for telehealth and how hospitals, providers, and organizations can prepare.
What’s at Stake for Telehealth?
During the pandemic, Congress enacted temporary measures to expand telehealth access, including provisions allowing Medicare beneficiaries to access services from their homes, using a broader array of technologies. These measures are set to expire at the end of 2024 unless Congress acts to extend them.
A government shutdown would delay legislative action to extend telehealth flexibilities, potentially leaving millions without the virtual care options they’ve come to rely on. Here are the key impacts of a shutdown on telehealth:
Loss of Telehealth Flexibilities for Medicare Beneficiaries: Services that are currently reimbursable via telehealth may revert to pre-pandemic policies, restricting access for rural and underserved populations.
Regulatory Uncertainty for Providers: Providers would face confusion over which services they can deliver via telehealth, impacting operational workflows and billing practices.
Increased Administrative Burden: Without clear guidelines, hospitals and clinics may need to reconfigure their telehealth programs to align with outdated rules, diverting time and resources.
Potential Service Gaps: Patients requiring ongoing telehealth services, particularly for behavioral health and chronic conditions, might experience delays or disruptions in care.
What Can Organizations Do to Prepare?
While the potential outcomes are concerning, hospitals, health systems, and providers can take proactive steps to mitigate the impact of a shutdown and prepare for the expiration of telehealth flexibilities.
To navigate the uncertainty surrounding telehealth during a potential government shutdown, organizations must take proactive and strategic steps. Start by reviewing current policies and procedures: audit telehealth workflows to pinpoint services tied to temporary flexibilities, and update your staff on anticipated changes should those flexibilities lapse. Educate your patients by keeping them informed about potential shifts in telehealth availability and guiding them toward in-person care or alternative solutions if needed. Compliance training is equally essential—ensure your billing teams are well-versed in pre-pandemic telehealth policies, and hold workshops on Medicare and Medicaid rules to prevent reimbursement issues. Diversify funding sources by seeking grants or local partnerships to keep telehealth programs afloat and exploring collaborations with private insurers who remain committed to virtual care. Lastly, advocate for telehealth by joining industry coalitions to lobby Congress for extended flexibilities and engaging in public awareness campaigns to highlight telehealth’s critical role in ensuring equitable and efficient healthcare access. These efforts will empower organizations to weather the storm and continue providing innovative, quality care.
How Can Providers Stay Resilient?
Leverage Private Insurance Coverage
As telehealth has gained prominence in recent years, many private insurance companies have recognized its potential to reduce costs while improving patient outcomes. Insurers increasingly view telehealth as a strategic tool to lower emergency room visits, reduce hospital readmissions, and manage chronic conditions more effectively. Providers can capitalize on this trend by fostering stronger relationships with these payers. Engage in regular dialogue with insurance representatives to understand their telehealth policies and identify areas of mutual benefit. Additionally, tailor telehealth offerings to align with payer priorities, such as expanding behavioral health services or remote patient monitoring, which are often reimbursed at favorable rates. Establishing these partnerships not only ensures service continuity but also creates opportunities for innovative care delivery models that benefit both patients and providers.
Focus on Hybrid Care Models
While telehealth is a vital component of modern healthcare, a hybrid care model that blends virtual and in-person visits offers the best of both worlds. This approach ensures that patients continue to receive high-quality care, even if telehealth flexibilities are reduced or reimbursement policies change. For example, routine follow-ups and consultations can be conducted virtually, while physical examinations and procedures are reserved for in-person visits. Providers should consider mapping out care pathways to determine which services are best suited for virtual delivery and which require face-to-face interaction. Hybrid models can also enhance patient satisfaction by offering flexibility and convenience, particularly for those managing chronic illnesses or requiring ongoing mental health support. By integrating telehealth seamlessly into their broader care strategies, organizations can remain resilient and responsive to changing regulations.
Enhance Technology Infrastructure
A robust telehealth platform is critical for delivering efficient and effective virtual care. Streamlining telehealth technology can not only improve patient engagement but also reduce operational costs. Providers should invest in user-friendly platforms that simplify the patient experience, from scheduling appointments to accessing care. Enhanced features, such as AI-powered triage systems or integrated health records, can further elevate the quality of care while optimizing workflows for clinicians. To ensure long-term sustainability, organizations should also focus on interoperability, enabling seamless data exchange between telehealth platforms and electronic health record systems. Regularly updating cybersecurity measures is equally important to protect patient data and maintain trust. By prioritizing technological upgrades, providers can position themselves as leaders in telehealth innovation, prepared to meet both current and future healthcare challenges.
Even with uncertainty, providers can focus on innovation and adaptability:
Leverage Private Insurance Coverage: Many insurers have embraced telehealth as a cost-saving measure. Providers should strengthen relationships with these payers to maintain service continuity.
Focus on Hybrid Care Models: Blending telehealth with in-person visits ensures patients receive care even if virtual care is disrupted.
Enhance Technology Infrastructure: Streamline telehealth platforms to improve patient engagement and reduce operational costs.
The Bigger Picture
Telehealth has revolutionized healthcare delivery, improving access and patient outcomes, especially in behavioral health and chronic disease management. However, without legislative action to sustain current flexibilities, the healthcare system risks losing these advances.
Organizations must stay informed, advocate for long-term telehealth policies, and prepare contingency plans to minimize disruption. By taking these proactive steps, providers can continue to deliver quality care, even in uncertain times.
Conclusion
A government shutdown and the expiration of telehealth flexibilities pose a dual threat to the future of virtual care. Providers, hospitals, and stakeholders must act now to prepare for potential disruptions while continuing to advocate for the permanent integration of telehealth into the healthcare system.
Congress must recognize that telehealth is no longer a temporary solution but a vital component of modern healthcare. Extending telehealth flexibilities is not just a legislative priority—it’s a healthcare necessity. CTeL is hopeful for positive and forward-thinking congressional action. Stay tuned and engaged with CTeL to find out the latest information as it unfolds.