Schooner Blog

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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, [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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, [...]

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 [...]

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’ [...]

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 [...]