Over the past several months, significant changes surrounding telehealth and its role in healthcare have taken place. Changes include, CMS’ new, more generous reimbursement policies and several state laws spurring the progression of telehealth programs to address the opioid crisis. These changes reflect the greater movement towards telehealth as an affordable option to improve healthcare access and quality of care. To meet the rising demand for telehealth services, federal and state agencies, as well as nongovernmental organizations, have expanded grant funding for telehealth programs.
In December of 2018, the Agriculture Improvement Act of 2018, more commonly known as the Farm Bill, was signed into law. While the Farm Bill is arguably the largest example of the Federal government’s commitment to increase funding for telemedicine programs, several smaller programs also expanded their funding. The increase in grant funding comes as industry experts point to a need for telehealth expansion in rural areas to combat the opioid crisis, to tackle the growing physician shortage in rural areas, and to improve services for mental health treatment.
The Farm Bill of 2018 has approved increased funding for The Distance Learning and Telemedicine (DLT) Program through fiscal year 2023. The DLT Program was created under the Farm Bill of 1996 and placed under the jurisdiction of the United States Department of Agriculture (USDA). Since 1996, DLT programs have served as the largest federal provider of telemedicine-related grants.
Not only does the 2018 Farm Bill fund the grant program for five years, but it has further increased the DLT budget from $75 million per year to $82 million per year. While some critics have argued this increase is insufficient, others argue that the recipient requirements will contribute to the spread of telehealth in ways that will best address the largest issues in healthcare: physician shortages, quality of and access to care, mental health treatment, and the opioid crisis.
Grants will be awarded to provide job training, education on telehealth and telehealth services, and for the purchase of telehealth hardware. For example, St. Anthony Hospital in Oklahoma received nearly 500,000 in grant funding in late 2018 to purchase equipment for a telehealth program that will serve over 6,000 patients. This program will enable St. Anthony Hospital to provide rural patients with increased access to specialty care services such as cardiology, endocrinology, pulmonology, and mental health, thus addressing several of the above outlined issues plaguing the healthcare industry.
Washburn University in Kansas was also awarded funding in the latest round of grants from DLT. The WU program consists mainly of educating students and health care professionals on telehealth. Through education, this program aims to increase quality of care provided through telehealth and decrease physician and nursing burnout that is a contributing factor to physician shortage.[ii]
In order to address the opioid crisis, the Farm Bill designates $20 million of the $82 million yearly budget for programs that address treatment for opioid addiction and/or corresponding mental health programs. Organizations eligible for this funding must utilize telemedicine for either preventative educational measures for communities, treatment or training of clinicians, or recovery programs for those afflicted by opioid use disorders (OUDs). [iii]
Although the USDA through DLT programs is the largest source of federal funding for telehealth programs, other programs have also followed the trend of embracing telehealth and are expanding their grant programs.
Through their Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Health and Human Services (HHS) has earmarked nearly $50 million in grant funding for telehealth programs and other health care measures for Native Americans and Alaskan Natives. Similar to USDA programs, the SAMHSA grants aim to increase Medication Assisted Treatment (MAT) through telemedicine. MAT programs combine mental health treatment with opioid use recovery treatment and have thus far seen great success in treating OUDs.[iv]
In addition to SAMHSA, HHS is distributing $11 million to more than 100 school-based telehealth programs to address mental health and substance abuse, along with childhood obesity. For many students, school-based health centers are the first point of contact with a clinician or with the healthcare system at large, especially in underserved areas.
The Patient-Centered Outcomes Research Institute (PCORI) is a non-profit organization created by Congress nearly a decade ago in 2010. Several months ago, PCORI announced it will dedicate more than $31 million in funding to telehealth programs for the purpose of expanding the research base on telemedicine and improving quality of care. Results achieved by the recipient institutions could prove instrumental in expanding telehealth funding and reimbursement in future years.[v]
In addition to national program expansion, several states have received federal funding to expand telehealth services, or have used their own budgets to fund telehealth expansion.
The State of New Jersey was awarded over $2.2 million over a five-year period by the Health Resources and Services Administration (HRSA) to expand telehealth services aimed at improving screening for children with mental and behavioral health disorders.[vi]
In early 2018, the California Department of Healthcare Services announced their plans to expand telehealth services through a state-operated MAT program. California invested 2.3 million to incorporate telehealth into service delivery, equipment, and counseling programs.
The federal program expansions, along with expansions at the state level and grants sponsored by non-governmental organizations, follow an overall trend of growing confidence in telehealth to combat pivotal issues in the healthcare industry.