The increased use of hospice telehealth during COVID-19 has reduced 911 calls and emergency department visits, generating significant cost savings. Preventing those events is a key priority for Medicare and other payers, and hospices can leverage their successes on those metrics to attract referral partners and health plans.
Among a group of 44 hospice patients, emergency department visits and 911 calls dropped to 4.5% for those who received a telehealth intervention, down from 54%, according to a study published in the journal Computers Informatics Nursing.
Telehealth utilization swelled during the pandemic. Hospices will likely continue expanding these services in the long run to supplement in-person care. Telehealth has been a crucial avenue for hospices to continue reaching patients in a time of social distancing and severely restricted access to facility-bound patients.
“A telemedicine hospice care application may benefit a palliative and hospice organization by enhancing patient clinical outcomes and decreasing emergency department visit rates,” according to the study. “There were statistically significant differences in the number of emergency department visits and 911 calls between the two points in time.”
The patients involved in the research had 24-hour access to hospice clinicians via telehealth during the study period.
Hospices have been able to continue interdisciplinary services via telemedicine for patients who are receiving routine home care. Telehealth has played a vital role in the ability to continue reaching patients and their families to maintain continuity of care while limiting in-person contact that could spread the COVID-19 virus.
Provisions related to hospice telehealth were molded into the $2.2 trillion CARES Act, designed to help the economy and essential industries weather the COVID-19 storm. These included permitting practitioners to recertify patients via telemedicine rather than face-to-face encounters. During the federally declared national emergency, the U.S. Department of Health and Human Services waived certain regulatory requirements under section 1135 of the Social Security Act, allowing the U.S. Centers for Medicaid and Medicare Services (CMS) to relax telehealth rules.
A Senate bill proposed in May could make many of those temporary telehealth flexibilities permanent. If enacted, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021 would do just that, while expanding Medicare telehealth coverage.
Data tracking a provider’s performance on reducing emergency department visits, hospitalizations and readmissions will be essential for hospices seeking to participate in value-based payment programs. These include the direct contracting models and the value-based insurance design demonstration, often called the Medicare Advantage hospice carve-in. These payment models incentivize reductions in high acuity utilization.
Hospices also see value in the efficiencies that telehealth can create, including reduced travel time and expenses for staff to reach a patient’s location. Nearly half of respondents (47%) of respondents to Hospice News’ 2021 Hospice Industry Outlook Report indicated that telehealth would yield the highest return among technology investments this year compared to 2020. Telehealth outpaced other solutions such as predictive analytics (20%) and electronic health record systems (29%).