Where digital health coverage lags

The ideas and innovators shaping health care

Sep 19, 2023 View in browser   By Shawn Zeller, Carmen Paun, Daniel Payne and Erin Schumaker TECH MAZE Digital health tools could make more of a difference if more insurers covered them, the AMA says. | AFP via Getty Images Medicare is leading the way in covering virtual health care, with private insurers and Medicaid lagging behind. That’s according to a new report from the American Medical Association and consulting firm Manatt Health. They found that traditional Medicare and private Medicare advantage plans are paying doctors for: — remote patient monitoring, in which patients use medical devices to keep track of their vital signs at home. — remote therapeutic monitoring, which allows physicians to track a patients’ adherence to a care plan. — digital evaluation and management, in which patients contact providers via an online portal. — interprofessional telephone, internet, and electronic health record consultations, in which providers discuss a patient’s care with each other. By contrast: Medicaid coverage varies by state, the report says, with 34 states covering remote patient monitoring. Fewer states cover the other areas. Private insurers were all over the map. The report names 16 companies. Some cover all of the digital health work and others little of it. Why it matters: Virtual care exploded during the Covid pandemic, but the AMA contends that its promise — expanded access to care for patients and reduced administrative burden for providers — remains unfulfilled. The AMA cited the lack of coverage in Medicaid and private insurance as a cause of a “digital health disconnect,” and the group’s president, Jesse M. Ehrenfeld, said insurers would have to start paying for digital health offerings if they want more doctors to adopt the new tools.   GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here.     WELCOME TO FUTURE PULSE Spirit Island, Canada | Shawn Zeller This is where we explore the ideas and innovators shaping health care. You can now buy bottled, clean Tasmanian air if you’re concerned about air pollution, the BBC reports. A canister offers around 130 breaths and costs about $19. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Ben Leonard talks with POLITICO health care reporter Chelsea Cirruzzo about the new CDC director's plans to improve communication and transparency at the agency. Listen to today’s Pulse Check podcast WORLD VIEW Blinken's pressing his foreign counterparts to help with the fentanyl fight. | Chip Somodevilla/Getty Images The Biden administration is hoping international cooperation will stem the flow of illicit fentanyl, a powerful synthetic opioid that can kill people in small amounts. This week’s meeting of the U.N. General Assembly is the venue the administration is using to encourage more of it. Secretary of State Antony Blinken has announced three new initiatives to combat the fentanyl flow: The U.S. will name an envoy to work with foreign governments. The U.S., in partnership with the U.N. Office on Drugs and Crime, will partner with tech companies to stop drug trafficking online and to help people seeking substance use disorder treatment. The U.S. will introduce a resolution at the General Assembly’s meeting in December highlighting the threats posed by illicit synthetic drugs and urging international action. The backstory: The Centers for Disease Control and Prevention estimates drug overdose deaths reached nearly 110,000 last year, a record level, mostly caused by illicit fentanyl. The drug is produced in Mexico with raw chemicals sourced from China and sometimes routed through other countries before reaching Mexico. Blinken launched an international coalition against illicit synthetic drugs in July, which included 80 countries, including Mexico. China is not part of the coalition.   JOIN US ON 9/20 FOR A TALK ON TRANSFORMING HEALTHCARE BILLING: Bipartisan legislation in the House and Senate would align costs for services across hospitals and doctors’ offices and reduce out-of-pocket spending that could potentially save the federal government billions of dollars. Can this legislation survive a polarized Congress? Join POLITICO on Sept. 20 to explore this and whether site-neutral payments and billing transparency policies could help ease health care costs. REGISTER HERE.     CONNECTING THE DOTS Wastewater testing for signs of disease has uses beyond Covid, a new study found. | AP During the pandemic, public health workers with seemingly strong stomachs examined their communities’ sewage to detect surges in Covid-19. They’re eager to continue, believing it will help hospitals get ready for influxes of patients. The success with Covid has prompted new efforts to identify upticks in other respiratory diseases, including in Wisconsin, where state employees surveyed waste from treatment plants in Milwaukee, Madison and Green Bay for signs of respiratory syncytial virus and flu during last fall’s and winter’s respiratory disease season. Why it matters: The results were helpful for public health officials looking to forecast disease spread. Concentrations of the diseases in wastewater samples were correlated with increased emergency room visits, usually after the spike in wastewater data was detected. Viral material remained detectable in wastewater for up to three months after a spike in ER visits subsided.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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