Preparing for the Next Phase of Virtual Care and Remote Patient Monitoring

Tina Voss
Product Marketing Manager, XIFIN

Melanie Phan
Product Marketing, XIFIN

On July 15, 2022, the COVID-19 federal Public Health Emergency (PHE) was extended for an additional ninety (90) days. Many wonder when the PHE extension will end and what that will mean for virtual care and remote patient monitoring industries. If the PHE ends after this last extension, the Consolidated Appropriations Act, 2022 ensures a 151-day extension that allows certain virtual care and remote patient monitoring flexibilities to continue.

Now, healthcare providers are wondering what the future of the virtual care industry looks like during this transition period. Will virtual care still play a role in our nation's healthcare system? Will providers be reimbursed for virtual care and telehealth services? 

Several possible scenarios could play out once the PHE is lifted.

Scenario 1: Entering the Pre-COVID World

We are back to where we started before COVID existed. Medicare and Medicaid coverage for a range of virtual care services are slim. Patients with public health insurance in non-rural and more urban areas may have difficulty accessing virtual care services. While other patients with private insurance may still have access to virtual care, coverage may vary as rules change.

Scenario 2: Stalling and Studying

Before making permanent decisions, policymakers may extend the PHE for another 90 days or pass short-term reimbursement extensions, which gives them time to study the cost structure of longer-term virtual healthcare reform. This would also allow policymakers to explore how expanding virtual healthcare services may impact the quality of patient care, patient safety, and potential fraud.

Scenario 3: Virtual Care is Here to Stay

Congress acknowledges that virtual healthcare is here to stay, voting on substantial reforms to permanently reimburse for virtual care and telehealth services or at least keeping some billing guidelines set during the COVID-19 pandemic. A couple of options may happen – lawmakers may mandate telehealth payment parity which requires the insurer to pay for virtual care services at equal rates to in-person office visits. The second option is a discounted reimbursement rate for virtual care services.

Scenario 4:  Virtual-first Primary Care Takes Off

While virtual-first primary care is growing, it is not the status quo. Payment parities currently in place will expand virtual healthcare coverage with a focus on virtual-first primary care to the underserved and rural areas. Additionally, payment parity will allow the acceleration and adoption of remote patient monitoring products and services, providing a broader range of virtual care to a greater population of patients.

Scenario 5: Becomes a Pillar of Value-Based Care

Virtual care is valuable because it takes down barriers to healthcare services by providing a foundation for care coordination and communication between providers and patients. Enabling communities access to more convenient forms of preventative care will support a shift from the current health care system to a value-based care model.

With the right policies in place, virtual care and remote patient monitoring could be here to stay and flourish even after the pandemic. The transition towards virtual care as a patient-centric, value-based model will improve patient access to healthcare while enhancing the patient experience.

Are you aware of the many hidden costs impacting medical device and remote patient monitoring organizations?

Watch the on-demand Fierce Healthcare webinar to hear from XIFIN's Krista Nadolski and Clarissa Blattner and learn how to uncover and quantify these hidden costs.

Watch Now

Published by XiFin
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