Health Policy RoundUp 4.30.19

 

This week in Sacramento many telehealth-related bills related made their way out of the Assembly Health Committee on to Appropriations. In particular, AB 744 which would establish payment parity for telehealth services, made it out of Senate Health. However, the bill faces uncertainty due to health plan opposition and a California Health Benefits Review Program analysis which estimates of a total increase in health care costs of $278.2M if the bill passes. Bill advocates may maintain confidence, however, as New Mexico’s governor just signed the state’s own payment parity bill.

 

Legislative/Regulatory Developments

News Articles

Research & Reports

Funding Opportunities

Forthcoming Policy Hearings and Meetings

Legislative/Regulatory Developments

 

California

AB 744: Establishes payment parity for telehealth services for both private and public payers

  • passed Assembly Health, referred to Appropriations

AB 848: Requires Medi-Cal to cover blood glucose monitoring devices

  • passed Assembly Health, referred to Appropriations

AB 1264: Reinforces that an in-person exam is not required to prescribe birth control virtually

  • passed Assembly Business and Professions, referred to Appropriations

AB 1642: Requires Medi-Cal managed care plans to report to DHCS and an external quality review organization on their use of telehealth and health IT to meet time and distance standards, among other requirements

  • passed Assembly Health, referred to Appropriations

AB 1676: Requires private and public payer coverage of provider-to-provider mental health consultations for maternal and early childhood mental health

  • passed Assembly Health, referred to Appropriations
  • amended to specify coverage of live video and telephone consultations

SB 24: Requires UC and CSU campuses to provide access to medication abortions; access may be through telehealth

  • passed passed Senate Education, referred to Appropriations

 

Other States

New Mexico SB 354: Establishes payment parity for telehealth services in the state 

 

  • signed by Governor April 4

News Articles

 

Role of family doctors “clouding” with expansion of telehealth and walk-in clinics The nature of primary care is changing as the use of telehealth, drugstore clinics, urgent care centers and worksite clinics increase among patients. Only 25% of adults have a regular doctor, reports the Kaiser Family Foundation. Facing competition for patients as well as primary care provider shortage, primary care practices are creating teams that include specialists to provide a broader assessment of patient health. Read more from Associated Press.

Telehealth and direct-to-consumer pharmacy business Ro valued at $500 million 
Launched under the name Roman in 2017, Ro has completed a Series B round of funding and is now valued at $500 million. The direct-to-consumer telehealth business offers $15 online doctor consultations and then provides instant prescriptions for generic drugs that are the filled by the company’s cloud-based pharmacy. Read more from Tech Crunch.

UCLA Researchers Are Testing the Impact of Virtual Reality on Depressive Symptoms
A group of psychiatry researchers at UCLA are testing the ability of virtual reality (VR) to treat depressive symptoms by increasing positive feelings. Using VR technology, patients are put into “pleasant scenarios” where they can “soak up good feelings” to impact their anhedonia. Read more from STAT.

Research & Reports

 

Journal of Stroke and Cerebrovascular Diseases Telehealth Eliminates “Weekend and After-Hours Effects” for Acute Ischemic Stroke Patients Outcomes for  stroke patient in-person treatment  on weekends or overnight have been shown to be worse at many stroke centers. University of Texas Health Science Center researchers’ analysis of 424 telemedicine evaluations and management of stroke patients reports no difference for patients treated on weekends or after-hours, showing that the delivering care via telehealth does not differ based on hour or day.

AHRQ Comparative Effectiveness Review Telehealth for Acute and Chronic Care Consultations AHRQ’s assessment of the effectiveness of telehealth consultations and exploration supplemental decision analysis reports that while results vary by setting and condition generally outcomes are either better or no different from comparators. The report includes the following findings:

  • Remote intensive care unit consultations likely reduce mortality
  • Specialty telehealth consultations likely reduce patient time in the emergency department
  • Telehealth consultations in emergency services likely reduce heart attack mortality
  • Remote consultations for outpatient care likely improve access and clinical outcomes

The report concludes that increasing interest and investment in telehealth “suggests the need to develop a research agenda that emphasizes rigor and focuses on standardized outcome comparisons that can inform policy and practice decisions.”

Funding Opportunities

 

NIH & AHRQ: Planning Grants for Pragmatic Research in Healthcare Settings to Improve Diabetes and Obesity Prevention and Care (R34 Clinical Trial Required) Seeking proposals for pilots addressing diabetes and obesity prevention focused on “approaches with the potential to be broadly disseminated outside the specific setting where it is being tested”. Proposals due 5/14/19.

NIH & AHRQ: Pragmatic Research in Healthcare Settings to Improve Diabetes and Obesity Prevention and Care (R18 Clinical Trial Required) Seeking proposals to test innovative strategies for diabetes and obesity prevention in “healthcare settings where individuals receive their medical care”. Proposals due 5/14/19

NIH: Use of Technology to Enhance Patient Outcomes and Prevent Illness (R01 Clinical Trial Optional) NIH seeks proposals on the use of technologies, including remote healthcare, that improve patient outcomes. Ongoing standard NIH application dates.

USDA: Distance Leaning & Telemedicine Grants USDA seeking proposals to support SUD morbidity and mortality reduction in high-risk rural communities by expanding prevention, treatment and/or recovery capacities at community, county, state, and/or regional levels. Proposals due 5/15/19.

Forthcoming Policy Hearings and Meetings

April 29th: Senate Health Committee, Bill Hearing

April 30th: Assembly Health and Legislative Audit Information Hearing on Medi-Cal Children’s Preventive Services

April 29th: California Health Care Foundation Briefing: Improving Quality in Medi-Cal Managed Care

May 6th: California Health Care Foundation Briefing: Expanding the Scope of Practice for Nurse Practitioners