What’s the post-pandemic future of telemedicine in NJ?
TRENTON — Among the temporary changes made in response to the coronavirus pandemic is that insurers reimburse doctors the same amount for telehealth visits as they would for in-person ones. A debate is already underway before the Legislature about making that payment parity permanent.
Judd Hollander, senior vice president of healthcare delivery innovation for Jefferson Health, which serves Camden, Burlington and Gloucester counties, said patients are being seen more than a week sooner and there are far fewer cancellations. He said the method for delivering care shouldn’t matter for the reimbursement rate.
“A payer has never, ever reimbursed a cardiologist and asked: Which stethoscope did you use? They wouldn’t know if they used a high-powered cardiology stethoscope or a Fisher-Price stethoscope,” Hollander said at a Senate health committee hearing. “Honestly, they wouldn’t know.”
Brendan Peppard, regional director of America’s Health Insurance Plans, said there shouldn’t be a requirement that reimbursement rates be equal because the same time and equipment aren’t always needed.
“Telehealth should not become a replacement for needed in-person visits,” Peppard said. “We do not want to create an inappropriate incentive to substitute telehealth for a necessary in-person visit, which could be an inadvertent result of payment parity.”
Dr. Kennedy Ganti, president-elect of the Medical Society of New Jersey, said telehealth is a supplement for in-person visits, not a replacement, and that there are ways for parts of basic physical checkups to take place virtually.
“A lot of technology, particularly predicated on smartphones, like the iPhone, Android devices, allow for connectivity over the Bluetooth standard,” said Ganti, a physician at Cooper University Healthcare. “There are many glucometers, blood pressure monitors, scales that connect via this.”
Dr. Diane Reidy-Lagunes, associate deputy physician-in-chief of the regional care network for Memorial Sloan Kettering Cancer Center, said telehealth has also helped bring whole families together for end-of-life conversations no cancer patient wants to hear.
“One of the hardest parts of my job is to have some end-of-life conversations. And so many of our patients because of visitor restrictions were coming to clinics alone,” Reidy-Lagunes said. “So you can imagine not having family support, it was really hard when you were having these most challenging conversations.”
Reidy-Lagunes said before COVID-19, less than 1% of Memorial Sloan Kettering’s New Jersey patients were receiving telehealth services but that now 13% are – amounting to about 42,000 telehealth visits.
As the coronavirus pandemic enters its ninth month, and with a surge underway that could surpass New Jersey’s spring peak, concerns are growing about people’s general health.
Nancy Fitterer, president and chief executive officer of the Home Care and Hospice Association of New Jersey, said people are getting sicker because they aren’t seeing their doctors or taking care of themselves.
“And the pandemic has lasted so long. This wasn’t two weeks, three weeks, it’s been months now,” Fitterer said.
Dr. Lauren Carruth Mehnert, board chair for the New Jersey Academy of Family Physicians, said telehealth can help with that – people keep their appointments and are more likely to follow care directions. She understands if people are unwilling to come in for visits but prefers video appointments as an alternative.
“The number of people who are not exercising, taking care of themselves, alcohol intake. Their sugars are elevated, their cholesterol is elevated, their liver enzymes are elevated. Some of them have blood issues with the alcohol,” said Carruth Mehnert, who works at Capital Health in Ewing.
“They don’t want to come back in, and it’s not a phone call. My nurse can’t do that. That’s my job,” she said. “And a telephone, I can’t see them, I can’t read their facial expressions talking to them. And this is perfect for telemedicine, we make a plan, and they get better.”
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