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  • Oct 25, 2025

    Amid Medicare Policy Uncertainty, Recent Research Shows Value of Telehealth

    CCHP
    A recent Journal of General Internal Medicine study, Comparative Analysis of Clinical Outcomes Related to Telehealth and In-Person Encounters Among Older Veterans with Diabetes, found that telehealth can lead to improved patient satisfaction, continuity of care, and clinical outcomes. The study assessed Veterans Health Administration data from 2019-2021 to examine the use of hybrid telehealth, which is telehealth-based care in addition to in-person care, for chronic disease management. As noted in a Bioengineer article discussing the study, telehealth has emerged as a critical modality for delivering healthcare to the veteran population, who often reside in rural areas with limited access to conventional, in-person medical services. Moreover, telehealth offers a realistic solution to the mobility challenges often experienced by this demographic.  As we enter a time-period where telehealth access is now limited to certain populations due to the expiration of Medicare telehealth waivers as of October 1, 2025 (see CCHP’s recent newsletters for more information), ensuring policymakers are aware of all data highlighting telehealth’s value becomes that much more important.

    The Journal of General Internal Medicine study focuses on the benefits telehealth provides to geriatric populations. In terms of continuity of care, telehealth can increase ongoing patient-provider communication and ensure the ability for consistent monitoring, which is especially important for those with multiple co-existing health issues. Further, the option to conduct follow-up visits via telehealth may improve treatment adherence rates and clinical outcomes. Telehealth may also help to increase patient education, empowering patients to better understand their conditions and implement self-management strategies. Such strategies can be critical to chronic disease management such as diabetes control. The article does also mention barriers to telehealth, including limited internet connectivity and device accessibility, signaling the need for future policies to further promote telehealth access and improve patient comfortability with utilizing technology.

    Also highlighted is the need to integrate telehealth as standard practice in the management of chronic conditions among older populations. And, by doing so, this may also be a more cost-effective model for healthcare delivery as well as holding the potential to improve patient satisfaction and outcomes. Integrated care such as this can allow for more consistent tracking of conditions and might allow for earlier interventions before more serious impacts on the patient’s health may occur.

    Additionally, while telehealth generally remains a policy area with bipartisan support, due to the lack of Congressional agreement on a funding approach to avert a government shutdown last month, the Medicare telehealth waivers which have ensured expanded access to care over the past five years, have now expired. Many still anticipate another extension of the Medicare telehealth waivers at some point in time, but it is currently unknown when and if that may occur and consequently, just how long this gap period may continue. The culmination of these elements has created much uncertainty around the sustainability of telehealth for both providers and patients. As a result of the now expired waivers, disruptions in care will definitely occur. For instance, the Centers for Medicare and Medicaid Services (CMS) issued a notice regarding the Acute Hospital Care at Home (AHCAH) initiative, which was also implemented within federal Medicare telehealth expansions in 2020. The notice advises all hospitals with active AHCAH waivers to discharge, or return to the hospital, all inpatients on September 30, 2025, due to the lack of Congressional action to extend the program under the telehealth waivers. CMS stopped accepting AHCAH requests for participation on September 1, 2025.

    Additionally, as reported in CCHP’s special #TelehealthThursday newsletter edition last week, CMS has issued updated guidance regarding Medicare telehealth claims during the shutdown. CMS first released an update on October 1, 2025 via a special edition of the Medicare Learning Network (MLN) Newsletter, stating that when legislative payment provisions are scheduled to expire, CMS directs Medicare Administrative Contractors (MACs) to implement a temporary claims hold, typically of up to 10 business days. The hold is meant to prevent a large reprocessing of claims if Congress acts after the statutory expiration date, which was September 30, 2025. As the 10-day period expired on October 14, CMS issued an additional claims hold update on October 15, 2025, stating that in anticipation of possible Congressional action, CMS has instructed all MACs to continue to temporarily hold claims with dates of service of October 1, 2025 and later for services impacted by the expired Medicare legislative waivers. See the most recent CMS claims hold update and CCHP’s last newsletter for more information.

    Furthermore, CMS updated its Telehealth FAQ document as of October 15, 2025 to reflect the changes in effect as of October 1, 2025, consistent with the legislative waiver expirations at the end of September. Two of the issues CCHP has recently received many questions regarding appear to now be addressed in the updated FAQ – payment for federally qualified health center (FQHC) and rural health clinic (RHC) non-behavioral health services via telecommunications technology, as well as application of in-person visit requirements to behavioral health services provided post-September 30, 2025. The updated FAQ from CMS confirms that, consistent with information supplied by CCHP in previous newsletters and prior CMS guidance, FQHCs/RHCs can continue billing for non-behavioral health services delivered through telecommunications technology by reporting HCPCS code G2025 on the claim through December 31, 2025. Additionally, the updated FAQ confirms that FQHC/RHC behavioral health in-person visits remain waived at least until January 1, 2026. In regard to general in-person behavioral health requirements (applicable to non-FQHC/RHC telehealth providers) during this post-waiver period, CMS clarifies in the updated FAQ that the initial 6-month in-person requirement will not be required for telehealth patients established prior to September 30, 2025, however the one in-person visit every 12 months thereafter requirement will continue to apply. For more information and discussion on these issues and CMS’ updated FAQ, see CCHP’s last newsletter.

    Ultimately, until permanent policies incorporating recent flexibilities are adopted for telehealth within the Medicare program, a level of uncertainty will remain regarding continued telehealth access. In the past, policymakers have been hesitant to make Medicare telehealth expansions permanent in the absence of further studies, therefore amplifying more research remains important to ensure the full potential of telehealth can be realized across all patient populations.

    For more information regarding the veteran’s telehealth study, please access the full analysis. For more information regarding the recent expiration of Medicare telehealth waiver policies, see CMS’ updated Telehealth FAQ and review CCHP’s recent newsletters and resources regarding the return to more restrictive Medicare policies:

    CCHP Newsletters: CCHP Resources:

    See original resource at : https://www.cchpca.org/resources/amid-medicare-policy-uncertainty-recent-research-shows-value-of-telehealth/

     

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