Nebraska

Nebraska hospitals raise concerns about cuts to telehealth payments

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OMAHA — The Nebraska Hospital Affiliation is elevating considerations on behalf of its members about current cuts by Blue Cross Blue Defend of Nebraska to the quantity it pays suppliers for medical telehealth visits. 

Jeremy Nordquist, the affiliation’s president, mentioned Blue Cross now’s paying suppliers of medical telehealth visits half of what the insurer pays for in-office medical visits. The discount in funds got here in a few of the new agreements between the insurer and hospitals that went into impact July 1. 

“It is a devastating minimize, it is a shortsighted minimize that can actually put an finish to telehealth in Nebraska if that is the course payers are going to go,” he mentioned Tuesday. 

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Blue Cross officers mentioned in an announcement Tuesday that the brand new reimbursement fee nonetheless is at or above pre-pandemic reimbursement charges. Blue Cross will not be the one service within the business making such reimbursement changes now that the pandemic has eased, the officers mentioned.

Within the early days of the pandemic, Blue Cross voluntarily expanded fee of telehealth providers so individuals may get the care they wanted. In March 2020, telehealth utilization shot up greater than 1,000% over February 2020 numbers.

Though telehealth utilization stays larger than pre-pandemic figures, it has continued to steadily lower — about 30% 12 months over 12 months — for the reason that peak in early 2020, in accordance with the insurer’s assertion. As vaccines have change into extensively accessible and the quantity and severity of instances has decreased, most individuals have returned to pre-pandemic actions, together with in-person visits with their suppliers.

However Nordquist mentioned many suppliers will not have the ability to afford to supply telehealth medical care on the decrease fee. Analyses by group employees and conversations with hospital officers point out that the prices for suppliers with brick-and-mortar amenities to ship telehealth visits aren’t a lot totally different from the prices of providing in-person visits. Suppliers’ time dedication is just about the identical for each forms of visits, he mentioned.

Whereas a few of the state’s bigger well being programs have supplied cheap telehealth visits, notably through the pandemic, Nordquist mentioned he’s listening to that the associated fee equation could trigger some to rethink a few of these choices. 

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Nebraska does have a legislation, adopted in 2021, that requires that reimbursements for behavioral well being telehealth visits be the identical as for in-person behavioral well being visits.

However an identical measure, LB314, that may have required parity in reimbursements for medical visits didn’t advance, Nordquist mentioned. At the moment, Blue Cross officers informed legislators that they had no plans to tug again from their telehealth fee parity place as a result of they thought it met the wants of the market.

In 1999, Nordquist mentioned, the Nebraska Legislature adopted a legislation requiring fee parity inside the state’s Medicaid program. On the nationwide stage, Medicare nonetheless pays suppliers on the similar fee for telehealth and in-person visits, though that’s an administrative coverage that’s topic to alter.

Nordquist mentioned the individuals who will undergo most if telehealth had been restricted within the state are rural residents who drive many hours to see specialists and folks in city settings who face transportation challenges. Through the 2021 parity invoice hearings, Omaha endocrinologists testified that they had been efficiently treating diabetes in sufferers across the state.  

“Actually, telehealth is about comfort and getting individuals entry to care once they want it,” Nordquist mentioned.

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On a current name, he mentioned, United HealthCare officers informed him that that they had no plans to maneuver away from parity in funds.

The hospital affiliation, he mentioned, will search to influence insurers to revisit medical telehealth parity through the subsequent legislative session. Nordquist mentioned he’s assured new laws might be launched. He mentioned he thinks the impetus will come from rural senators who’ve seen telehealth increase entry to care of their districts. 



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