What happened in health care technology this week, and why it’s important.
CMS improves Medicaid reimbursement for Digital Health consults
The Centers for Medicare & Medicaid Services has issued guidance changing Medicaid and CHIP coverage for eConsults, or provider-to-provider specialty consults conducted via digital health or telehealth, Eric Wicklund reports in Health Leaders. The ruling changes the payment model so that the consulting provider, or the specialist, can bill for the treatment. Previously, CMS allowed the treating provider to bill Medicaid, which in many cases forced the program to pay higher rates to the treating provider so that they could reimburse the specialist for consulting services.
Why it’s important – Alongside helping primary care providers retain more of their patients, the platform is popular with federally qualified health centers (FQHCs) and community health centers that treat underserved populations and in rural areas where access to specialists is scarce. It also helps specialists expand their reach and treat more patients needing their services.
Infographics of the week – This infographic comes from a Boston Consulting Group analysis of emerging developments in the healthcare metaverse. I especially like the timeline perspective about when these will reach maturity.
This week’s second infographic comes from Dr. Bertalan Mesko and his team at The Medical Futurist Institute. It provides an excellent overview of how digital health technologies will impact different physician disciplines.
Remote therapeutic monitoring is reimbursable – here’s what you need to know
Bill Siwicki interviews an RTM and digital care-management expert. He walks readers through how the new CPT codes can help provider organizations meet patients where they are: at home in his article in Healthcare IT News. Since CMS released the new CPT codes for remote therapeutic monitoring last year, health systems have been eager to use them but unsure of the criteria. Providers are acknowledged for their time connecting with patients outside of the office—an excellent overview of the topic for those trying to understand the importance of the new codes.
Why it’s important – With the new CPT codes, providers can get reimbursed for:
- Educating patients on how to use a remote care-management platform.
- Monitoring a platform’s alerts and patients’ use of remote education.
- Direct patient/provider messaging within the platform.
- Data collection via the platform, i.e., collecting patient feedback on pain levels, activity and motion.
Wearable Sensor Uses Ultrasound to Provide Cardiac Imaging On the Go
Engineers and physicians have developed a wearable ultrasound device that can assess the structure and function of the human heart. The research was highlighted on the UC San Diego Today website. The portable device, roughly the size of a postage stamp, can be worn for up to 24 hours and works even during strenuous exercise. The wearable heart monitoring system uses ultrasound to continuously capture images of the heart’s four chambers from different angles and analyze a clinically relevant subset of the images in real-time using custom-built AI technology. The project builds on the team’s previous advances in wearable imaging technologies for deep tissues.
Why it’s important – Cardiac imaging is an essential clinical tool to assess long-term heart health, detect problems as they arise, and care for critically ill patients. This new wearable, non-invasive heart monitor for humans provides real-time, automated insights on the difficult-to-capture pumping activity of the heart – even when a person is exercising. Thanks to custom AI algorithms, the device can measure how much blood the heart is pumping. This is important because the heart not pumping enough blood is at the root of most cardiovascular diseases. And issues with heart function often manifest only when the body is in motion.
Video of the week – This is an excellent discussion on how to innovate by Astro Teller, the “Captain of Moonshots” at Google X. Teller challenges the conventional approach to creating moonshots and describes how he and his team at X decide what to work on and, just as important, when they’ll pull the plug on a project. Well worth watching.
How AI Is Detecting Heart Attack Risk And Aiming To Outsmart America’s No. 1 Killer
Cardiologist James Min, former professor at Weill Cornell Medical College and director of the Dalio Institute of Cardiovascular Imaging at New York-Presbyterian, founded Cleerly to find a better way to assess heart health by applying AI to the problem, cutting down on the time it takes to flag issues and ultimately reach his goal of a “heart-attack free” world. His startup’s quantitative comparison tool tracks patient disease by the amount and type of atherosclerosis (plaque) rather than indirect surrogates, including risk factors, symptoms, stenosis (narrowing of the aortic valve), and ischemia (blood flow restriction). Jason Junior reports the story in News AZI online.
Why it’s important – Cleerly is standardizing and personalizing the approach to heart disease with a pathway that enables the ability to identify and characterize, educate, implement, treat, and track disease over time to prove therapeutic success in patients before they experience a catastrophic heart event. Cleerly has and continues to conduct several multicenter clinical trials to demonstrate its accuracy. In two seminal studies published last year, Cleerly demonstrated 99% accuracy against the consensus of three board-certified, level III expert physician readers and 86% accuracy against invasive coronary angiograms (ICA). In the latter study, Cleerly demonstrated higher agreement with invasive fractional flow reserve (FFR) — the physiologic gold standard for coronary artery disease evaluation — than ICA.
CVS Health goes live with virtual care service with a focus on primary care, mental health
Heather Landi brings us the story in her article in Fierce Healthcare online. As part of its new virtual primary care service, CVS Health is expanding telehealth-based mental health care to include appointments with licensed therapists and psychiatrists. The retail drugstore giant announced its virtual care offering last May to give consumers access to primary care, on-demand care, chronic condition management, and mental health services. As part of the new service, CVS is expanding its virtual mental health services to provide members access to support, seven days a week, from clinicians, including appointments with licensed therapists and psychiatrists.
“Mental health care is a fundamental element of well-being. We know that we have better results when we treat the whole person, which is why we believe it is important to bring mental health services into primary care. And today, mental health needs are becoming more urgent.”
Creagh Milford, Senior Vice President, Retail Health, CVS Health
Why it’s important – CVS executives say the virtual primary care offering is part of the company’s strategy to provide “longitudinal and holistic care to create stronger relationships between patients and their providers.” Recent CVS Health and Harris Poll data show that consumers prefer telehealth. Respondents somewhat or strongly agree that telehealth appointments are quicker to provide care (77%), more convenient (76%), and make appointment scheduling easier (75%) compared to other healthcare options.
UK Government plans 500% expansion of virtual wards
This story from the UK, written by Jon Hoeksma, was featured in Digital Health News online. The UK government plans to expand the use of virtual wards to treat up to 50,000 patients a month. As well as growing virtual wards, the government says it will expand community services, including falls and frailty teams and urgent community response teams. The announcements come as part of efforts to reduce intense pressures and record waiting times for NHS services and ongoing strike action by nurses and ambulance staff.
Why it’s important – Virtual wards are considered a safe and efficient alternative to hospital care, particularly for frail and elderly patients. High-tech virtual wards currently support frail elderly patients or those with acute respiratory infections and cardiac conditions. Patients are reviewed daily by the clinical team, who may visit them at home or use video technology to monitor and check how they are recovering. In the UK, supporting vulnerable patients at home and in the community may lead to up to 20% of linked emergency hospital admissions caused being avoided.