Behavioral Providers’ Role in Shaping Post-COVID Telehealth Rules

Telehealth has been vital in helping behavioral health providers navigate the COVID-19 pandemic. Regulatory flexibilities and payer leniency are largely to thank for that, but it’s unclear which of those freedoms will remain in place post-pandemic.

Behavioral stakeholders from some of the health care industry’s largest organizations believe that data and provider input should ultimately drive those decisions, informing when virtual care is appropriate to use in the future of behavioral health.

“When the public health emergency goes away, we don’t want it to go back to ground zero,” said James Laughman, president of the specialized behavioral health managed care company PerformCare. “I cannot see an automatic stop to [telehealth], but I do think we need to have really clear conversations about quality, efficacy and safeguards around people’s health.”

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Laughman made those comments during a recent webinar hosted by World Congress, a global provider of health care conferences. His company, PerformCare, is a subsidiary of AmeriHealth Caritas, a managed care company that serves about 4.5 million members across 13 states.

When it comes to developing the telehealth regulations of the future, Laughman said it’s important for rulemakers to consider quality — namely that virtual care is held to the same quality standards as in-person care.

“We need to have that apples-to-apples comparison,” Laughman said. “We can’t set a different standard of quality measures. The HEDIS measures should stay the same [and] the star measures should stay the same so that we in fact understand the efficacy of what has taken place.”

Quality is important because not every type of care is best delivered virtually. For example, many autism providers have reported that it can be tough to deliver applied behavioral analysis (ABA) to children virtually, rather than in person.

In the same vein, different care modalities may work better for different populations. For example, audio-only telehealth has proven to be especially effective for seniors, who aren’t always comfortable navigating technologies such as Zoom.

“Being able to … see what works for different populations in different areas and different age groups, etc, will allow for true appreciation and education of the clinicians,” Yener Balan, who was a panelist alongside Laughman on the webinar, said.

Balan is the vice president of behavioral health and medical specialties at Kaiser Permanente health plan and hospitals. He said knowing what works will ultimately inform payers’ telehealth coverage decisions going forward.

As such, providers who can demonstrate the successes they’ve had with telehealth amid the pandemic will have a leg up as we begin to enter the post-pandemic world.

“If you’re a provider … [and] you have information that shows that [telehealth] is working for designated populations, please share that information,” Laughman said. “[Make] that you’re going back to state regulators, CMS, primary insurance payers. Your voice in what has been best for your patients … is really an important thing to consider.”

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