BlueCross BlueShield: Permanent Telehealth Benefits

Recently BlueCross BlueShield of Tennessee announced that it is making coverage of in-network telehealth service a permanent part of its benefit packages, including telehealth

With the COVID-19 pandemic keeping many Americans home, telehealth services have emerged as an alternative to in-person care, and BlueCross BlueShield aims to increase its availability. Prior to this telehealth was an option for some medical services, however, most insurances did not cover physical, occupational, and speech therapy delivered by this method. 

Telehealth is not a new concept. In fact, in the early 1900s when radio revolutionized communication it wasn’t long before innovators started imagining how doctors could attend to patients over the radio. In 1924 a radio news magazine featured an illustration of a doctor attending to a patient via video call, under the headline “The Radio Doctor–Maybe!”.  During the1940s  radiology images were sent 24 miles between two townships via telephone line in the world’s first example of an electronic medical record transfer. A Canadian doctor built upon this technology in the 1950s, constructing a teleradiology system that was used in and around Montreal. As these practices became more widespread, so did motion pictures, and with the advent of modern film technology came serious plans for video medicine. The first people to use video communication for medical purposes were clinicians at the University of Nebraska. In 1959, the university established a two-way television set up to transmit information to medical students across campus, and five years later linked with a state hospital to perform video consultations.

Since then telemedicine has grown and expanded. Patients and the medical community have seen the advantages of conducting these types of visits. As per Sloan Kettering, these include:

  • Getting the care you need without having to travel to the hospital/clinic.
  • Saving travel time and money.
  • Helping you spend less time at your healthcare provider’s office.
  • Not having to have a caregiver travel with those who can not transport themselves

“During this global pandemic, telehealth is emerging as an effective and sustainable solution for precaution, prevention, and treatment to stem the spread of COVID-19. Telehealth is bridging the gap between people, physicians, and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels, helping to reduce the spread of the virus to mass populations and the medical staff on the frontlines, said Dedi Gilad, CEO, and co-founder of Tyto Care, a telemedicine technology company. Critically, hospitals are quickly adopting telehealth to treat quarantined patients infected with COVID-19.”

The American Physical Therapy Association has been a long time advocate for physical therapists and physical therapists assistants providing services via telehealth. From their position to the House Of Delegates (TELEHEALTH HOD P06191509 [Initial: HOD P06140707] [Position]): 

“Telehealth is a well defined and established method of health services delivery. Physical therapists provide services using telehealth as part of their scope of practice, incorporating elements of patient and client management as needed, to enhance patient and client interactions. The American Physical Therapy Association (APTA) supports:  

  • Inclusion of physical therapist services in telehealth policy and regulation on the national and state levels to help society address the growing cost of health services, the disparity in accessibility of health services, and the potential impact of health workforce shortages;    
  • Advancement of physical therapy telehealth practice, education, and research to enhance the quality and accessibility of physical therapist services; and 
  • Expansion of broadband access to provide all members of society the opportunity to receive services delivered via electronic means. 

With these advantages, support of governing bodies, and the technology being quickly put into place, many clinicians wonder if after the pandemic this option will remain. Many insurances have put an end date in place for coverage, however, there is some speculation that these will be extended or removed. 

Recently BlueCross BlueShield of Tennessee announced that it is making coverage of in-network telehealth service a permanent part of its benefit packages, including telehealth delivered by physical therapists, occupational therapists, and speech therapists. The change is the first time a major insurer has extended telehealth coverage beyond the length of the current public health emergency.

“Providers and patients have indicated that they believe telehealth provided for therapy and many other services is not only efficient but effective — and not just during a public health crisis,” said Carmen Elliott, APTA’s vice president of payment and practice management. “This innovative step by BlueCross BlueShield of Tennessee is encouraging, and hopefully other payers will see the same promise in telehealth as a permanent offering.”

The insurance states “In March, the mission-driven insurer began covering telephone and video visits with in-network providers.  The change initially included primary care providers, specialists, and behavioral health providers and was later expanded to include occupational, physical, and speech therapy as well as ABA therapy services. All of these services will now be covered on an ongoing basis”.

“We’re committed to helping our members get the care they need, and telehealth offers them and the providers they trust with more options that fit their everyday needs,” said JD Hickey, president, and CEO. “This recent period has proven virtual care can work for preventive, routine, and maintenance care, and we’re making this decision because the added convenience can bring better health.”

BlueCross telehealth coverage includes both member-to-provider and provider-to-provider consultations, and it has seen health care providers across Tennessee demonstrate increasing support for these services.

Will other insurances follow their lead? Many feel that it is possible. The American Physical Therapy Association states:

Telehealth may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or subspecialists, and impaired mobility. Examples of PTs using telehealth technologies include the following: 

  • PTs provide interventions using telehealth by observing how the patient moves and performs exercises and activities. They provide verbal and visual instructions and cues to modify how the patient performs various activities and may change the environment to encourage optimal outcomes. 
  • PTs provide consultative services by working with other PTs, physical therapist assistants, and other health care providers to share expertise in specific movement-related activities to optimize the patient’s participation. 
  • PTs provide quicker screening, assessment, and referrals that improve care coordination and increase the probability of patients completing plans of care. 

Telehealth already is being used to treat patients with a variety of chronic conditions such as renal disease, diabetes, mental health, and substance use disorders, and holds promise for a broad range of patient populations, including those enrolled in Medicare. Emerging evidence indicates that telehealth can empower both patients and health care providers to offer the best approaches to care that consider patient demographics, location, and diagnoses; provide high-quality, cost-effective care; and reduce disparities in care, especially in rural communities. While it does not eliminate the need for in-person visits, telehealth does increase access to a greater variety of providers and can enhance delivery and coordination of care.

Consider visiting the BlueCross BlueShield website for more information.

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