Telehealth has surged during the COVID-19 pandemic, offering an opportunity for patients to stay connected with their healthcare providers without jeopardizing their physical safety. Because individuals with I/DD are at greater risk for contracting the virus, telehealth has been a significant resource to ensure this at-risk population can maintain their physical and mental healthcare needs.
Rising Utilization
Telehealth, also referred to as telemedicine, is not new. Up until the country-wide shutdown in the Spring due to COVID-19, telehealth had not experienced widespread support from doctors and patients. In recent months, however, telehealth has gained popularity. According to a recent survey, a third of Americans have chosen to use telehealth services since the start of the pandemic, and 45% now consider it “very effective.” In addition, 55% of those surveyed said they felt it was safer and also could improve access to their usual services.
Between December 2019 and May 2020, telehealth use by patients in the U.S. increased on average from 8% to 29%. This included both primary care and mental health services considered necessary but non-emergent. For Medicare patients, telehealth use increased significantly in 2020, largely due to emergency legislation that eased payment and access restrictions, such as allowing patients to see doctors in other states.
In Massachusetts, Blue Cross Blue Shield went from covering 200 telehealth visits per day prior to COVID-19 to almost 4,000 telehealth visits per day as of this summer. A recent analysis from FAIR health, a nonprofit focused on health data, determined remote medical services claims across the country were 8,000% higher in April 2020 than they had been in April 2019. In New York, which is considered by infectious disease experts as one of the first epicenters of the virus, telehealth claims rose 26,209% during the same time period.
Challenges And Possibilities
Access to physical and mental health services seems to be the greatest telehealth game-changer in the midst of a global health crisis. As nursing homes across the country were shut down, residents were able to utilize telehealth to continue needed therapies, including physical, occupational and speech services. Individuals with I/DD have been able to use telehealth for consistency and continuity in their care by gaining access to doctors, psychiatrists, and other specialists without having to leave their homes.
One pilot program in New York successfully decreased emergency room visits for individuals with I/DD, and caregivers reported 93% of those living in group homes included in the pilot were happier and less anxious with the virtual visits. In this case, initial diagnoses were made in person, but subsequent mental health appointments (including management of medication and therapy services) could be conducted remotely with the assistance of a direct service professional (DSP). Although the program pilot began prior to COVID-19, this process of screening ensures early detection of infection and enables providers and caregivers to move quickly when residents become ill.
An Ongoing Resource
While not all visits can be conducted via video or phone, states are still moving to secure funding to help cover as many types of viable visits as possible. In June 2020, Missouri signed an agreement with a telemedicine company to provide services to 15,000 Medicaid Waiver users at no cost. A $13 million grant for New York will enable individuals with I/DD to access emergency room doctors through telehealth kiosks, thus reducing risk of exposure and potentially reducing infection rates. In North Carolina, providers of health services that serve at-risk populations, such as those with I/DD, substance use disorders, or mental health conditions, are advocating for further state funding and support so they can continue to serve providers who are working to keep those in their care safe and healthy.
Thus far, the general consensus within the medical community is that telehealth is here to stay, with some providers advocating that the expanded coverage and legislative changes necessitated by the virus should remain permanent. Those advocating for ongoing legislative support are also looking for ways to make improvements, such as increasing equitable access and expanding support into rural areas. No matter the future of the coronavirus and the state of post-pandemic healthcare, telehealth services will continue to be a helpful resource for providers and individuals with I/DD.