Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

Clinicians in A-APMs that include financial risk for total Medicare spending and quality of care would be able to leverage most telehealth expansions, including higher payment rates for telehealth services and the delivery of telehealth to patients in non-rural areas and in patient homes.

Reimbursement for telehealth would also encourage participation in the alternative payment models, which is the ultimate goal of the Quality Payment Program.

Providers participating in the general Medicare fee-for-service system would not get the same telehealth flexibility in this post-pandemic world, though.

Allowing telehealth reimbursement expansions to continue throughout Medicare after the pandemic would require guardrails considering large healthcare fraud cases involving fraudulent billing of services ordered via telehealth.

Providers in A-APMs do not face the same incentives to overuse telehealth services, the analysts explained.