In January, Congress passed a bill to approve most of the budget for the remainder of the fiscal year. That bill included a huge win for digital health, value-based care, and health innovation: a two-year extension of the waivers on Medicare payments for live audio-video telehealth visits. We at the Connected Health Initiative, along with many of our colleagues in the digital health space, have been strongly advocating for this extension and applaud Congress’s work on this issue. You can read our recent statement on the extension here.
Congress has been doing a lot of work on improving Medicare’s use of telehealth. On January 8, the House Committee on Energy and Commerce held a hearing titled “Legislative Proposals to Support Patient Access to Medicare Services,” to which CHI submitted comments for the record. You can see our full statement here, but for the highlights, keep reading.
In addition to our championship of Medicare telehealth waivers (which we have written about extensively, see blogs here and here, as well as a letter here), we also advocate changes to how software as a medical device (SaMD) is treated by Medicare’s payment system. The current payment structure treats cutting-edge diagnostics software the same as Microsoft Word, despite the massive gulf between those types of software’s usages—and clinical value to practitioners and patients. Grouping these different types of software together in the lower-tier “indirect practice expense” payment category discourages the use of high-tech SaMD by putting its cost out of reach for many healthcare providers. Although the Centers for Medicare & Medicaid Services (CMS) has been asking the health tech community questions about proper payment for years, we still have yet to see modernization in the way CMS treats new health technologies.
Our statement for the record in the January 8 hearing keyed in on these CMS payment dynamics, focusing in particular on the use of artificial intelligence (AI) in healthcare. We believe AI health tools will be a critical part of keeping our health system functioning as need continues to grow. Estimates suggest successful use of AI applications will create $150 billion in annual savings for the U.S. healthcare economy alone by the end of this year (note that this savings estimate should be considered conservative, as it only includes a “top 10” of AI scenarios). Because improved patient outcomes for Medicare beneficiaries will entail allotting resources to services other than those addressing acute and chronic illnesses, AI can help bring the right resources to the right areas to support additional services such as therapy, tailored case management, habilitative services, and transport and translation costs. We need policymakers in both Congress and the executive branch to continue supporting AI health tools, pushing for their reimbursement through Medicare, and encouraging medical professionals to utilize health tools that make their lives easier.
We are glad that Congress continues to examine ways to incorporate health innovations into healthcare and urge policymakers to keep up the good work!
