Telehealth in Medicare Medicaid:The Hidden Hero

This program prevents everyday situations where patients forget to follow through with the doctor's orders from the initial check-up, which leads them to showcase more problems on the next visit. Their goal is to guide their patients on the path to wellness.

What Makes "Doctor to Door" Medicine Special

Clay fondly remembers when he answered a call from a patient's daughter where she was thanking him for Dr. Porter's, one of his doctors' acts of kindness. What happened was, Dr. Porter visited a senior home to do a check-up on the caller's mother. When she got there, Dr. Porter found that the patient hadn't eaten anything in days, so she decided to cook her breakfast.

The doctor ended up spending two hours with the patient and running late for her next appointment. In usual hospital settings, Dr. Porter would have been in trouble for being an hour late to her next engagement, but Clay commended her because what she did perfectly exemplified what they do and why they do it.

In hospitals, physicians are scrambling around in a hurry to see as many patients as possible. But when they are doing home preventive care, physicians focus on the quality of care they give instead of the quantity. Having the time to sit down, drink coffee, and talk comfortably in a patient's home develops an authentic connection between doctor and patient that is just not possible inside a clinic setting.

However, we cannot disregard the fact that there will be times when the patient's situation calls for in-hospital treatment. Having access to 24/7 monitoring, comprehensive testing, and specialists right at your fingertips is something home care cannot provide yet. Clay clarifies that home care is not a replacement for hospital care.

"It's not necessarily us versus them. It's more of working synergistically and using the resources we have at our disposal at the appropriate capacity, " he shares with Top Doctor Magazine.

Has Covid-19 Impacted Home-Based Care At All?

Because Clay and his team are running a homebased medical care system, they are fortunate that the pandemic's impact on them isn't quite as severe compared to other medical services. With telemedicine at the forefront now, he was pleasantly surprised to see that many of their older patients are now picking up smartphones.

"We are moving into a tech-savvy world for sure, " he claims. His company has even partnered with QliqSoft - where patients can now fill up medical information online through an app. He thinks that this technology can increase patient compliance and enrollment, therefore enhancing patient care. However, Clay's focus is still on getting physical hands and eyes on patients, but telemedicine is a fantastic alternative, especially with this pandemic.

Another fun fact about Clay Hall is that he is a big advocate for regenerative medicine. Even though regenerative medicine is still quite off-label due to a lack of clinical trials, he believes that it will become a massive player in medicine one day. There are already several successful reports wherein the amniotic fluid is being used to treat orthopedic injuries - and it is only a matter of time before this style of treatment will pick up in the mainstream.

Meanwhile, primary care providers should continue to focus on sitting down with the patient and re-educating them on the wonders of proper nutrition, exercise, and sleeping habits. Clay sees that going back to the foundations of health and sticking with a wellness-based intervention will help with the general goal of primary care to reduce polypharmacy, which uses several different pills to treat one illness. He hopes to see medicine shuffle towards a more natural and holistic way of healing.

Clay Hall's Advice for the Masses

As the world slowly starts to shift back into its pre-pandemic routine, Clay is worried that people are starting to let their guard down against COVID-19. That is why he urges the public to get the vaccine when they can, for it is a necessary act of human kindness. He says that if you don't want to get vaccinated to protect yourself, do it to protect others around you who are more susceptible to a fatal COVID-19 reaction.

Clay hopes that everyone, especially the lowincome population, will have the opportunity to get vaccinated and receive proper health care. And, to aid in making health care more accessible, Clay Hall and his team of physicians will continue to do their part in providing patients with value-based service and extensive continuous care.

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The Hidden Hero Keeping Us Connected to Our Doctors even in a Pandemic

“The genie is not going back in the bottle!”

In recent months, the Centers for Medicare and Medicaid Services (CMS) has expanded access to telehealth services under President Trump’s emergency declaration. This allows beneficiaries to receive a broader range of services from their doctors without going to a healthcare facility. These benefits are part of the larger effort put forth by CMS and the White House Task Force to ensure that all Americans - particularly those at high-risk - are aware and able to access systems that can keep them healthy.

Under the 1135 waiver, Medicare can now pay for office and hospital visits - among other types of visits furnished via telehealth across the country. This is a drastic change from before the waiver when Medicare could only pay for telehealth services on a limited basis.

As of October 14th, the CMS added eleven new services to the growing list of telehealth services that Medicare will reimburse during the COVID-19 public health emergency. Since March 2020, Medicare has added more than 135 services via telehealth that it will pay for, including emergency department visits and nursing facility visits. Seema Verma, the administrator of CMS, said of the additions: “Responding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country… This revolutionary method of improving access to care is transforming healthcare delivery in America. President Trump will not let the genie go back into the bottle (CMS.gov, 2020).

In the past three years, CMS has been working to modernize Medicare as part of the Fostering Innovation and Rethinking Rural Health strategic initiatives. It has unleashed innovation in the private sector, improving access to telecommunication technologies and services to beneficiaries. Starting in 2019, Medicare began paying for virtual check-ins where a patient can connect with doctors via phone or video chat. These check-ins were done as a preliminary way to assess whether the patient needed to come in for an in-person visit. However, in response to the COVID-19 pandemic, CMS rapidly expanded its payment for telehealth services. This allowed Medicare beneficiaries living in all parts of the country access to high-quality care from the comfort of their own home where they could avoid unnecessary exposure to the virus or other illnesses.

“Before the COVID-19 pandemic, only 14,000 beneficiaries received a Medicare telehealth service in a week while over 10.1 million beneficiaries have received a Medicare telehealth service during the public health emergency from mid-March through early-July” reports CMS.gov.

TELEHEALTH IN MEDICARE: WHAT DOES IT LOOK LIKE?

As the healthcare industry has had to rush to fill the gaps in coverage during the COVID-19 pandemic, CMS has made keeping people safe and avoiding unnecessary exposure to the virus a priority. Providing a fact sheet on the various telehealth services now allowed through Medicare, patients, and healthcare providers alike can seek guidance on the best options for personalized care. This historic effort has been made possible by new policies implemented in both 2019 and 2020.

For a beneficiary, these services can look like an inquiry call to their doctor if they are experiencing symptoms. During this call, it can be assessed whether a physical exam is needed or merely remote monitoring to see if symptoms worsen. If the beneficiary worsens, a virtual check-in allows the doctor a chance to make recommendations without making a patient step into the office or hospital.