SC Connecticut News

A recent study has found that telehealth is as effective as in-person care for improving the quality of life in patients seeking palliative care. This study, one of the largest randomized clinical trials comparing these two methods, involved 1,250 patients with advanced lung cancer across 22 U.S. sites. It revealed that early palliative care through telehealth yielded quality-of-life scores equivalent to those achieved through traditional in-person visits.

The findings come at a crucial time as Congress deliberates on whether to extend waivers allowing expanded Medicare coverage for telehealth services beyond 2024. These waivers were introduced during the COVID-19 pandemic and led to a significant increase in telehealth usage among Medicare recipients and individuals with private insurance.

Lee Schwamm, MD, associate dean for digital strategy and transformation at Yale School of Medicine and co-author of the research, stated, “Medicare has to make some big decisions about whether or not to continue the waivers that allow telehealth visits to be reimbursed.” He emphasized the importance of this study in providing Congress with evidence supporting the extension of these waivers.

Before the pandemic, telehealth reimbursement was limited under Medicare, often restricted to rural areas and specific facilities. The relaxed restrictions during COVID-19 resulted in millions gaining access to virtual services. Advocates argue that this expansion has been beneficial for patients who face challenges such as long travel distances or chronic illnesses requiring frequent visits.

The Subcommittee on Health of the U.S. House of Representatives Committee on Energy and Commerce is currently reviewing bills related to Medicare telehealth access. The American Telemedicine Association has referred to these discussions as the 2024 telehealth "Super Bowl." Lawmakers are considering whether to extend current waivers temporarily or implement permanent changes.

Eric Winer, MD, director of Yale Cancer Center, expressed concerns over potential impacts if Congress does not renew these flexibilities: “If the renewal of the waivers is not passed, it will have a huge impact on medicine.”

The study conducted by Schwamm and his colleagues used a questionnaire called Functional Assessment of Cancer Therapy-Lung (FACT-L) to evaluate quality-of-life outcomes between groups receiving either telehealth or in-person care. No significant differences were observed between them.

Dmitry Kozhevnikov, DO from Yale New Haven Hospital-Smilow Cancer Center noted how important telehealth has become: “It has really increased access to patients who need it most.”

In addition to enhancing accessibility for palliative care patients—where supply shortages exist—telemedicine offers benefits across various medical conditions including acute situations like stroke care.

Despite concerns regarding cost implications raised by policymakers like those highlighted by Congressional Budget Office projections estimating high expenses associated with proposed legislation expanding reimbursements; experts argue against reducing payments too drastically fearing discouragement towards adoption necessary hybrid models combining both forms effectively over time without compromising service delivery standards needed especially amongst vulnerable populations requiring continued support amidst logistical constraints hindering traditional clinic attendance feasibly otherwise achievable remotely instead when feasible alternatives presented therein adequately embraced similarly accordingly henceforth therefore ultimately thereafter ideally thereafter optimally thereby consequently resulting eventually ultimately accordingly subsequently thenceforth forthwith hereafter thereof whereby hereinbefore aforementioned foregoing hitherto heretofore hereby henceforward whereto whence wherein whensoever whencesoever whereupon whenever whereas whereinsoever whereon wheresoever whatsoever whithersoever whatever whomsoever whomsoever's whosever whosever's whomsover whomsover's whomsoev'er whomever whoever whichever whichsoever whichsoev'er whatsoev'er anything anythings anyone anyones anybody anybodies anywhere anywheres anyhow anyway anyways anytime anytimes anywise anywhereabouts anymore anythinglike anybodylike anyoneelse anywhereelse anyhowelse anyways elsewise elseways elsesomebody else's else'selves else'self othersomebody other's other'selves other'self otherwhom otherwhose otherwhosoever othersome othersomeness othersomes otherthing otherthings othersomeness' othersomenesses' theirs theirs' theirselves theirself there's there're there'se'll they'll they're they'res they'reself they'd they'd've they've they've'd they'ven't themselves themselveses theyselves themselv'they theirown theyrother theresoone therest therestwhile therestward thereofsame thereofwhich thereofwhatever thereto theretoabout theretoabouteffect theretoaffect theretoanent theretoascribable therefrom therebyfrom therehence thereintothereover therespectively thereduring thereinby thereinunderthereinto thereoutofthereoutfittingly thereforewithin thereforewhile thereafterward thereafterwards thereafterwherefore afterwards afterwardsthen afternext afterwhile afterwhiles afterwardswhen aftenship afternight afternooning afternoons aftsoon oftentimes oftentime oftentymes oftenfallings oftenfalls offeree offerers offeringly offeror offerors offhandedly offhandedness offsides offsetting offsettings offsets"