Bill Overview
Title: To amend title XVIII of the Social Security Act to allow for the furnishing of audio-only telehealth services.
Description: This bill permanently allows evaluation and management and behavioral health telehealth services to be provided via audio-only technology under Medicare.
Sponsors: Rep. Smith, Jason [R-MO-8]
Target Audience
Population: Individuals covered under Medicare including seniors and certain younger individuals with disabilities
Estimated Size: 64500000
- The bill impacts individuals who use Medicare, which primarily includes individuals aged 65 and older, as well as younger individuals with long-term disabilities or specific diseases.
- The bill focuses on expanding access to telehealth services, particularly benefitting those who have limitations accessing video telehealth services due to technological or connectivity challenges.
- Audio-only telehealth is crucial for individuals without access to broadband internet or advanced digital devices.
- The bill also impacts healthcare providers who deliver telehealth services and will now have expanded capabilities to offer audio-only consultations.
Reasoning
- The population of individuals impacted by this policy primarily includes older adults and individuals with disabilities who are covered by Medicare. They are more likely to face barriers in accessing video telehealth services due to limited technological capabilities or lack of access to broadband internet.
- The policy is designed to allow access to necessary healthcare through audio-only communication, which would help mitigate some of these technological barriers, particularly in rural or underserved areas.
- Budget constraints must ensure the cost-effectiveness of extending audio-only services does not exceed allocated funds, suggesting a phased approach in implementation might be necessary.
- Healthcare providers will also be affected by this policy as they might have to adjust their practice methods to include more audio-only sessions, which might require training and adaptation.
- Healthcare pay rates for telehealth services need to be adjusted accordingly to prevent service denial due to lower reimbursement for audio-only calls.
Simulated Interviews
retired (rural Tennessee)
Age: 72 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I often struggle to get to doctor's appointments due to distance and lack of transport.
- Audio calls are simpler for me than trying to use video apps.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 5 |
retired teacher (urban California)
Age: 66 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I like the option of audio calls because they feel more personal and less formal.
- It's convenient not having to set up video calls all the time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
disabled (rural Ohio)
Age: 45 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- I can attend appointments from home without worrying about travel costs.
- Audio calls make it easier to discuss issues without the need for expensive video equipment.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
retired (suburban Florida)
Age: 80 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I prefer in-person visits but understand the importance of phone calls.
- It's helpful to have quick phone check-ups versus lengthy in-person visits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
part-time worker (urban New York)
Age: 38 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- Audio-only calls have made it easier to maintain my healthcare without the stress of technology issues.
- This option is invaluable for continued management of my condition from home.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
retired farmer (rural Kansas)
Age: 76 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- Telehealth audio calls mean I don't have to travel long distances for every minor health issue.
- It is comforting to have healthcare access without needing to use difficult technology.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 4 |
disabled veteran (suburban Texas)
Age: 59 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Audio calls improve access when I'm unable to leave the house easily.
- It's a benefit that helps me stay consistent with my appointments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
retired nurse (urban Chicago)
Age: 85 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- I appreciate the option for quick audio consultations, even though I prefer in-person.
- Having phone options makes routine check-ups less cumbersome.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
recently retired mechanic (rural Alabama)
Age: 68 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- Phone calls are easier for me than figuring out video calls.
- I struggle with reading, so audio communication simplifies things.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 4 |
part-time caregiver (urban Oregon)
Age: 42 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Audio calls fit well with my caregiving schedule often better than clinic visits.
- They make periodic health updates and consultations easy and less disruptive.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Cost Estimates
Year 1: $300000000 (Low: $250000000, High: $350000000)
Year 2: $315000000 (Low: $265000000, High: $365000000)
Year 3: $330750000 (Low: $278250000, High: $383250000)
Year 5: $364857750 (Low: $307357500, High: $423607500)
Year 10: $451158251 (Low: $379200000, High: $522569942)
Year 100: $3869728992 (Low: $3252425189, High: $4487038963)
Key Considerations
- The impact of increased telehealth use on overall healthcare costs.
- Equity and accessibility improvements particularly in rural or underserved areas.
- Adjustments in healthcare provider workflows and infrastructure to accommodate audio-only services.
- Monitoring the impact on healthcare outcomes, particularly for chronic condition management.