Federal Government Authorizes Telehealth Waiver Pilots for Medicare Value-Based Care
Posted on February 26, 2019
Recent policy changes by the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) have been designed to make telehealth services more broadly available to Medicare beneficiaries. The changes follow a Congressionally-mandated report highlighting how reimbursement restrictions limit telehealth use, and so requirements have been relaxed for the Medicare [...]
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CMS Proposes Major Telehealth Flexibility for Medicare Advantage Plans
Posted on February 7, 2019
New telehealth benefits will be available for Medicare Advantage (MA) members if a proposed rule published November 1, 2018 by the Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) becomes final, as expected. The rule implements provisions of the Bipartisan Budget Act of 2018, effective for plan year 2020. The proposed CMS rule would permit Medicare [...]
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Federal Government Expands Medicare FFS Telehealth Services for Stroke, ESRD and Substance Use Disorder Services
Posted on January 16, 2019
The New Year is off to a good start for those involved in telehealth as changes to the Medicare Fee-For-Service program will bring expanded services to beneficiaries needing care related to stroke, End Stage Renal Disease (ESRD) and substance use disorder (SUD) and co-occurring mental health disorders. The U.S. Department of Health and Human Services (DHHS) Center for Medicare and Medicaid [...]
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Important Changes to Telehealth Services in Medicare Fee-for-Service Effective This Month
Posted on January 4, 2019
The Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) is in the process of modernizing the use of telehealth for both Medicare Fee-For Service (FFS) and Medicare Advantage (MA) plans. The agency realizes the advantages of telehealth for improving access and addressing cost and disparities even as the commercial market zooms ahead in utilization. To counter [...]
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CMS Identifies Barriers to Telehealth Use for Medicare Fee-for-Service Beneficiaries
Posted on December 21, 2018
In a recent blog post, CHQI examined the overall findings from a new telehealth report published on November 15, 2018 by the U.S. Centers for Medicare and Medicaid Services (CMS) that included data analysis highlighting current utilization, areas of growth and opportunities for improvement. The CMS report highlights how telemedicine and telehealth services are expanding for Medicare [...]
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Medicare Beneficiary Use of Telehealth Grows, Overall Adoption Remains Low with Major Opportunities for Expansion
Posted on December 11, 2018
A new report titled “Information on Medicare Telehealth” from the Centers for Medicare and Medicaid Services (CMS) shows relatively large growth in the use of telehealth services among Medicare Fee-for-Service (FFS) beneficiaries from 2014-2016. Yet, overall adoption remains low: Only a tiny fraction of the total Medicare FFS population currently uses telehealth. This is due in large part [...]
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First Wave of CHQI Telemedicine Accredited Organizations: Making a Difference
Posted on November 21, 2018
Since ClearHealth Quality Institute (CHQI) took over the American Telemedicine Accreditation’s (ATA) Accreditation Program for Online Patient Consultations last year, we have embarked on quite a journey in developing and launching the new CHQI Telemedicine Accreditation Program (TAP). By leveraging CHQI’s independence as a third-party accreditation agency and by maximizing ATA’s 25 years [...]
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Accreditation: Filling Regulatory Gaps in Quality-Based Healthcare
Posted on November 7, 2018
After launching more than 20 accreditation programs in healthcare since 1996, I have come to appreciate the important role accreditation standards play in filling regulatory gaps in the promotion of quality-based care. The reality is the U.S. healthcare system is much more complex than it was in the 1970s or 1980s.  Thus, the effectiveness of regulations governing health insurance or related [...]
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Just Announced: Fall 2018 Telemedicine Accreditation Workshops
Posted on August 28, 2018
Two of telemedicine's biggest and best conferences take place each fall and this year, CHQI is proud to offer a complimentary Telemedicine Accreditation Workshop at each one: the American Telemedicine Association EDGE 18 Conference and the Telemedicine & Telehealth Service Provider Summit (SPS). Why attend an in-person workshop? - Learn the value of the telemedicine accreditation, [...]
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What Is Mental Health Parity?
Posted on May 11, 2018
In the past, health insurance benefits for mental health and substance use disorder treatment were far more limited than for treatment for physical health conditions. Because of these disparities, often patients did not receive the care they needed to experience recovery. Mental health parity laws were enacted to remedy these inequities, requiring health insurers to cover mental health and [...]
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Understanding the Benefits of Accreditation 101
Posted on May 7, 2018
Accreditation programs currently exist for health care organizations, education institutions, and public health departments, among other groups. It’s safe to say most would agree that accreditation is a good idea.  But why should organizations consider spending time and money on the accreditation process?  What organizational and financial benefits could they receive as a result of [...]
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CHQI Activities at the 2018 American Telemedicine Conference
Posted on April 19, 2018
Headed to the 2018 American Telemedicine Association Conference this year?  We invite you to connect with the CHQI team in a variety of ways: 1) Register for CHQI’s Pre-Conference Accreditation Workshop on Saturday, April 28 from 1:00 PM - 4:00 PM.  The workshop is designed to guide you step-by-step through the Telemedicine Accreditation Program application process, including tips for [...]
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Legislative Update – Bipartisan Budget Act of 2018
Posted on March 1, 2018
On February 9, 2018, Congress passed and President Trump signed into law the Bipartisan Budget Act of 2018, which includes several key provisions that expand payment for telemedicine services under Medicare. Medicare covers almost 60 million Americans age 65 and over, as well as those under 65 who have disabilities. [1] The impact of the Act will be wide-ranging because commercial health [...]
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Mental Health Services are Hard to Access in Rural America: Telemedicine Can Help
Posted on November 13, 2017
To say those who live in rural America can have difficulty accessing mental health care, is an understatement. Two such barriers they face are transportation and the scarcity of providers in country settings. These combined issues place burdens on family physicians to provide mental health care when many patients truly need to see a psychiatrist. Appalachia is a region of the country that has [...]
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Telemedicine Medication-Assisted Treatment: A Key Part of Solving the Opioid Epidemic
Posted on November 9, 2017
If you’re reading this, you probably know someone – a family member, friend, or neighbor – who has overdosed from opioids. The President’s Commission on Combating Drug Addiction and the Opioid Crisis paints a grim picture in its Final Report, issued on November 2, 2017: in the U.S., more than 175 lives are lost to addiction every day. There is hope, however, because of the tireless [...]
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Hurricanes Harvey, Irma and Maria Remind Us that Telemedicine Can Help Provide Important Medical Care in Times of Natural Disasters
Posted on September 19, 2017
As Hurricanes Harvey, Irma and Maria brought destruction to the U.S. within a 30-day period, medical professionals rushed in to help of all stripes and colors. In addition to the traditional on-the-ground relief efforts, a growing number of doctors, nurses and others provided care remotely through the phone, video, smartphone apps and other telemedicine modalities. The provision of both emergency [...]
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UM “Prospective Review” Continues to Demonstrate Value
Posted on April 20, 2016
Since the advent and expansion of utilization management (UM) systems in the 1980’s, many changes and enhancements have been implemented.  Among other changes, many UM programs are now embedded in integrated medical management delivery models that often appear seamless to the patient or ordering provider.  Of course, many of the fundamental tools used in UM interventions are still around, [...]
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Utilization Management Programs Promoting Patient Safety
Posted on April 11, 2016
The evolution of utilization management (UM) interventions continue to open up new ways to promote best practices.  To that end, many health plans, care management organizations and other sponsors of UM programs have begun to focus on promoting emerging “patient safety” protocols even if these add to the over-all costs of paying for insurance. A recent example of this quality-based [...]
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UM Practices in Workers' Compensation
Posted on April 1, 2016
Workers’ compensation programs, as we know them today, have evolved over a 30-year period.  Over time, benefits were standardized, cost-containment and equity with state regulations was addressed, and return to work programs that benefit workers were introduced. As this evolution continues, the need to contain costs continues to be critically important. In 2011, state and federal workers’ [...]
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The Role of Accreditation in Utilization Management
Posted on March 16, 2016
Over the last 30 years, accreditation organizations have assumed an increasingly important role in filling regulatory gaps by establishing quality standards before similar provisions are adopted by states and federal governments. Supporters of private sector accreditation programs note that these nonprofits can work more efficiently create quality standards that fill important gaps in the health [...]
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