Reflecting on ATA NEXUS 2024: Essential Insights for Telehealth and RPM Providers

The XiFin team was thrilled to participate and present at the American Telemedicine Association (ATA) 2024 NEXUS conference. This is a critical year for telemedicine and remote patient monitoring providers. The flexibilities afforded telehealth providers during the pandemic-related public health emergency (PHE) are slated to end in December 2024. The ATA continues to work toward compelling Congress to make them permanent or, at a minimum, extend them.

The ATA advocacy efforts in this area address, among other things:

• Removing geographical and site-based restrictions
• Allowing Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to continue offering telehealth services with fair compensation
• Expanding the list of eligible Medicare providers
• Maintaining audio-only telehealth coverage permanently to ensure accessibility for patients who lack access to more advanced technologies

Positive news heard during the conference is that the House Ways Committee voted to extend the PHE-related telehealth flexibilities for two additional years (through calendar year 2026) by passing the Preserving Telehealth, Hospital, and Ambulance Access Act. The full House is expected to pass the Act later this year.

The conference highlighted several other significant points related to policy and telehealth reimbursement and the need for comprehensive, permanent reforms. Key policy priorities covered during the conference include:

Expansion of Coverage for All Individuals: To ensure all individuals in part-time or contracted positions have access to affordable telehealth services, certain flexibilities must be extended, and new legislation, such as the Telehealth Expansion Act, which aims to help individuals with high-deductible health plans, must be advocated for.

Regulatory Adjustments for Controlled Substances: To allow remote prescribing of controlled substances without an in-person requirement, enhancing accessibility and convenience for patients needing these prescriptions.

Data Privacy and the Ethical Use of AI in Telehealth: To build patient and provider trust in virtual care technologies, normalize telehealth in policy frameworks, and ensure it remains a viable and integral part of the healthcare system.

Nixon Gwilt Law made a great point in its post-event summary:

The XiFin team presented the importance of market access for telehealth, medical device, and remote patient monitoring providers. In a session titled “Strategies for Market Access, Building Payor Coverage, Adapting to Changing Payor Policies, and Maximizing Reimbursement,” Clarisa Blattner, XiFin’s Senior Director of Revenue and Payor Optimization, and Harley Ross, XiFin’s Chief Commercial Officer, discussed:

• The market dynamics driving the expansion of our distributed healthcare system.
• The core pillars of market access and how a collaborative approach to expanding market access is essential.
• How data and revenue cycle management expertise can support your market access and coverage expansion initiatives.

The Market Access Team cannot operate effectively as an island. It must take a strategic, cross-departmental approach, including the market access team, the commercial team (i.e., sales and client service), the billing and revenue cycle management (RCM) team, and the finance team. Collaboration is the key to success.

Leveraging data to make well-informed market access decisions is as vital as collaboration. Telehealth, medical device, and remote patient monitoring service providers must regularly analyze data to understand trends related to payor mix, relevant medical policies, and prior authorization (PA) requirements.

It is essential to share data across teams to prioritize and focus market access efforts and initiatives. It is also necessary to fully leverage data from your billing and RCM partner. Data from an RCM partner can help the team better understand average reimbursement for similar services, top denial reasons, and denial trends. Telehealth, medical device, and remote patient monitoring service providers can leverage their RCM partner’s contacts and relationships with payors and policy advisors.

Data, expertise, and analytics from the right RCM partner can support market access initiatives in several ways, including:

• Payor behavior and demographic insights
• Prior authorization trends
• Coverage determination support
• Billing compliance
• Contract negotiation
• Revenue forecasting

We concluded with the importance of advocacy. One way to get involved is through ATA Special Interest Groups, such as the Remote Patient Monitoring, Home Telehealth, and Government Relations special interest groups.