The cost of Congress’ telehealth waffling

The ideas and innovators shaping health care

Jul 17, 2024 View in browser   By Ruth Reader, Daniel Payne, Carmen Paun, Erin Schumaker and Toni Odejimi POLICY PUZZLE Congress has extended Medicare telehealth reimbursement, but hasn't updated it since the pandemic. Congress is taking its time to decide whether Medicare should permanently pay for telehealth. The Bipartisan Policy Center says that’s a mistake. The think tank’s new policy report advises legislators to adopt a long-term Medicare and Medicaid reimbursement strategy that gives providers reason to invest in the service. “The potential problem there is telehealth providers and investors won’t have that certainty needed to make long-term investments in telehealth infrastructure to support continuing to integrate telehealth into our larger health care system,” Maya Sandalow, senior policy analyst at the center, told Ruth. Extending the temporary telehealth rules adopted during the Covid pandemic, which are set to expire at the end of the year — and seems to be the most likely scenario — also perpetuates standards that made sense then but don’t now. For example, telehealth is reimbursed at the same rate as in-person visits under current rules. In some cases, such as mental health appointments, parity might make sense. But in other cases, it might incentivize providers to offer only virtual care, even when in-person care is needed, the report says. The Bipartisan Policy Center thinks Congress needs to consider a more nuanced reimbursement model that accounts for how telehealth care is delivered, such as via a quick email or a full video appointment. The policy paper suggests Congress consider bundling payments to account for short follow-up interactions related to an initial visit. Why it matters: Telehealth is an important facet of medical care, allowing patients to see doctors despite travel limitations and offering physicians an opportunity to connect with patients outside of traditional appointments. However, it needs to be funded. What’s next? While telehealth policy languishes in Congress, some states are setting their own, creating inconsistent rules nationwide. Private insurers are also setting their own reimbursement policies — often offering less than what they would pay for an in-person visit.   The CNN-POLITICO Grill has quickly become a key gathering place for policymakers and thought-leaders attending the RNC in Milwaukee. On Tuesday, POLITICO and Bayer convened two conversations: a discussion with Sen. John Boozman (R-Ark.) and Rep. G.T. Thompson (R-Pa.) and an executive conversation with Bayer’s Jessica Christiansen, senior vice president and head of crop science and sustainability communications. The conversations focused on the news of the day in Milwaukee, including deeper discussion centered on the critical challenges faced by the agriculture sector. CATCH UP HERE     WELCOME TO FUTURE PULSE Hull, Mass. | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. AI is providing a dystopian solution to Japan’s loneliness problem. People find companionship in AI bots provided by an app, Bloomberg reports. Some users see it as a good alternative to dating, which takes time and effort and doesn’t always work out. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, Erin Schumaker at eschumaker@politico.com, or Toni Odejimi at aodejimi@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.  EXAM ROOM A bot might be able to help with that. | AP Artificial intelligence chatbots may hold promise in drafting notes for health providers trying to answer patient questions — but with some caveats. A chatbot’s responses, when used to draft a clinician’s answer to a patient question, were rated as more empathetic and positive than notes from human clinicians, according to a new study published in JAMA Network Open. But the AI sometimes used complex or subjective language, attributes that could make health information less clear for patients. How’s that? Sixteen primary care clinicians reviewed nearly 350 responses to patient messages — about half of which were written by the chatbot. Reviewers offered mostly positive feedback for both clinician and AI responses, and the information’s accuracy, quality and completeness didn’t statistically differ between the two. Even so: In some areas, such as lab results, chatbots performed relatively poorly, which, according to the researchers, reinforced the need for benchmarking and careful implementation. The researchers also suggested more study will be required to understand the systems, given their work’s relatively small sample size and single-center focus. Why it matters: Doctors’ overflowing inboxes are often cited as a reason for burnout, and AI solutions to lighten the paperwork load are a hot commodity for provider groups. But some researchers and regulators are concerned that advanced AI, which is still a relatively new technology in the health care industry, isn’t ready for widespread rollout — at least not without more oversight.   Understand 2024’s big impacts with Pro’s extensive Campaign Races Dashboard, exclusive insights, and key coverage of federal- and state-level debates. Focus on policy. Learn more.     WORLD VIEW The Biden administration wants to boost cancer care in Africa. | AFP via Getty Images Reducing the toll of cancer in Africa was the subject of a Biden administration “cancer cabinet” conversation this week. It brought together government agencies, corporations, research institutions and advocacy groups to discuss strategies to lessen Africa’s cancer burden through prevention, detection, treatment and innovation. The conversation highlighted efforts underway and forthcoming investments, including: — The National Cancer Institute, health care company Roche and investigators in Kenya and Malawi are conducting some of the first cancer immunotherapy trials in Africa. — The cancer institute is also putting $15 million toward cancer research technology in low- and middle-income countries, $24 million toward cancer science implementation teams in Africa and $1 million toward investing in leadership modules at cancer research institutions in Africa. — The Centers for Disease Control and Prevention and its partners are expanding access to human papillomavirus vaccines, cervical cancer screenings and cancer treatment for women in Kenya. — Northwestern University’s Center for Global Oncology is putting $18 million toward launching a West Africa-U.S. Cancer Prevention and Control Initiative. — Drugmaker Pfizer is committing up to $1 million to improve breast cancer care in sub-Saharan Africa, as part of a program run by the American Society of Clinical Oncology. Why it matters: Cancer is the second leading cause of death globally and 70 percent of cancer deaths are in low- and middle-income countries, according to the World Health Organization. While cancer treatment is widespread in high-income countries, only 30 percent of low-income countries have access to it.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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