RISE reviews the latest headlines that have an impact on Medicare and Medicaid.

Public health experts worry now that CDC no longer oversees COVID-19 hospital data

As cases of coronavirus infections continue to skyrocket in the United States, the Trump administration this week stripped the Centers for Disease Control and Prevention (CDC) of its role in collecting hospital data for COVID-19. Hospitals must now submit information directly to the Department of Health and Human Services (HHS), a move that some worry means the White House is trying to sideline the CDC and the public will no longer have access to the data. During a media call on Wednesday, CDC Director Robert Redfield said CDC experts will still have access to the raw data that is collected, but it’s unclear when the information will be made available to the public. The dashboard was last updated on Tuesday, July 14, and the CDC directs information on future reporting to an HHS guidance document. José Arrieta, HHS' chief information officer, said during the news briefing that hospitals will now provide data reports to the newly created HHS Protect, which will consolidate COVID-19 data from hospitals, states, and other public and private sources. The federal government will use this information to help allocate resources as needed. Public health experts worry that the White House will try to control information and the public may not get the facts about infection rates, hospitalization rates, and death rates. “Whoever controls the data is in the driver's seat. They have the power," Christopher Ohl, M.D., a professor of infectious diseases at Wake Forest Baptist Health in Winston-Salem, N.C., told NBC News. "I'm concerned that we'll only get what their analyses and conclusions are, and there won't be any way to corroborate it."

CMS’ Verma shares data on telehealth, says agency working on long-term measures

The Centers for Medicare & Medicaid Services (CMS) efforts to expand telemedicine flexibilities during the COVID-19 pandemic has led to a surge in the number of Medicare beneficiaries who have received these services. In a Health Affairs blog post, CMS Administrator Seema Verma wrote that more than 9 million beneficiaries have received a telehealth service (audio-only visits, virtual check-ins, and evisits) during the public health emergency, mid-March through mid-June. Medicare FFS claims data also shows that:

  • More urban beneficiaries (30 percent) sought virtual care compared to rural beneficiaries (22 percent)
  • A higher percentage of those who live in the northeast region of the country (35 percent) took advantage of telehealth compared to those who live in the north central part of the country (17 percent)
  • Approximately 34 percent of dual-eligible beneficiaries used telehealth compared to 26 percent of those only on Medicare
  • Roughly 460,000 beneficiaries received telehealth services for mental health

Although she said that telemedicine can never replace the gold standard of in-person care, Verma wrote that it has proven to be a lifeline for health care providers and patients, and CMS is looking at which of the temporary changes can be made permanent through regulatory action. “As part of our review, we are looking at the impact these changes have had on access to care, health outcomes, Medicare spending, and impact on the health care delivery system itself,” she said, adding later, “The rapid adoption of telemedicine among providers and patients has shown that telehealth is here to stay. CMS remains committed to ensuring that the government supports innovation in telehealth that leverages modern technology to enhance patient experience, providing more accessible care.”

The permanent expansion of telehealth services has the support of health care providers and lawmakers. The House of Representatives this week has introduced a bipartisan bill that will allow CMS to reimburse for telemedicine services for 90 days after the public health emergency ends and will give HHS the right to waive telemedicine restrictions in Medicare during future emergencies and disasters. Industry groups, including HIMSS and the Health Innovation Alliance, have indicated support for the legislation.

CMS proposes Medicare payment changes to increase access for dialysis at home

A new proposed rule would pay providers additional money to use home dialysis equipment to treat patients who have end-stage renal disease (ESRD). CMS said the changes would encourage the development of new and innovative home dialysis machines, provide beneficiaries with more dialysis treatment options at home, and improve their quality of life. Currently, more than 85 percent of Medicare fee-for-service beneficiaries with ESRD travel to a facility to receive their dialysis at least three times per week and they spend, on average, 12 hours each week attached to a dialysis machine away from home. Dialysis patients are among the most vulnerable population covered by Medicare, as many of these beneficiaries have multiple chronic conditions and comorbidities. The proposed rule is part of several changes CMS is making to expand access to care for patients with ESRD. Earlier this year, it proposed a rule that will allow all patients with ESRD to enroll in Medicare Advantage (MA) plans in 2021. The changes and increased enrollment could have a significant impact on MA plans. Indeed, a new Avalere analysis finds that dual eligible beneficiaries with ESRD spend more on hospitalizations and ambulance rides than Medicare beneficiaries. “As MA plans prepare to enroll new patients with ESRD, it will be crucial for them to understand the characteristics and utilization patterns of the FFS population with ESRD so that they can effectively manage the care of these beneficiaries,” the Avalere report said.