Telehealth During and After COVID-19
In 2020, when the COVID-19 pandemic reached its peak, the government stepped in to help ease the burden of caring for the sick. The stay-at-home regulations restricted hospital visits, leading to more healthcare facilities engaging in telehealth (Provenzano et al., 2020). The Center for Medicare and Medicaid Services (CMS) increased access to telehealth services so that patients could access more benefits than they previously could without the need to travel to see the physicians. The policy changes by the CMS built on the regular flexibilities that were granted under the emergency Presidential declaration.
Under the Coronavirus Preparedness and Response Supplemental Appropriations Act and the 1135 waiver authority, CMS was able to expand the benefits on an emergency and temporary basis (Robeznieks & American Medical Association, 2020). Under the emergency waiver, Medicare could pay for hospital and office visits and virtual visits through telehealth in any State and the places of residents of the patients. These payments started on the 6th of March, 2020. This provision allowed for a wide range of healthcare practitioners, including licensed clinical social workers, clinical psychologists, physicians, and nurse practitioners, to offer telehealth services to their patients. Do you need urgent assignment help ? Our homework help will you tons of energy and time required for your homework papers.
In addition, the Inspector General at the HHS office provided healthcare providers with the flexibility to waive cuts or reduce cost-sharing for visits via telehealth through federal healthcare programs. Prior to the COVID-19 pandemic, the telehealth services reimbursement by Medicare was made at rates lower than the physical office visits. The payments are also needed for other parameters to be met, such as having a previous relationship with the healthcare provider. This is in addition to prohibiting a physical office visit that took place in the patient’s residence, and compliance with the HIPPA through telehealth tools such as Zoom could not be used (Medicare,2020).
As a nurse practitioner, I would advocate for telehealth reimbursement to be made permanent even after the pandemic. My first step is to have other nurses in my district and, consequently, the state sign a petition in support of the policy and have it passed as a law in the Senate.
Kingdon’s Model
Problem Stream: Regarding the provision of care access using telehealth in the prolonged national emergency state, it was clear that there was a problem. Even with the stay-at-home orders in place, people still needed to access telehealth services (Wosik et al., 2020). For example, patients still needed to access chronic disease management services, acute illnesses, and pregnancies continued, and children still had infections. These and many other illnesses still need to be attended to and would help ease congestion in the ER if telehealth was adopted. Those with chronic diseases especially are prone to get infected with COVID-19, and therefore, continuing telehealth services on a more permanent basis would be beneficial.
Policy Stream: During the COVID-19 pandemic in 2020, there was little time to draw a political process. Deaths were tallied daily on media, and the need for urgent action was intensifying by the day (Weinberger et al., 2020). At this time, it also became evident that elderly patients and vulnerable patients did not have continuous and reliable telehealth services via video. Changes were made to the telehealth policy to expand access to health through telephone and include exact parity in payment as in-person and video care. Telehealth should also include the implementation of infrastructure that will allow internet access to the vulnerable, elderly, and rural populations on a permanent basis, and with similar parity in payment, video, and in-person care.
Political Stream: The mood at the national and global arena in the COVID-19 pandemic was fear, which was coupled with panic at times. Epidemic shortages were experienced regarding bed space, nurse and physician availability, ventilators, and protective gear (Wu et al., 2021). The pressure was intensified for politicians to take action and help ease the shortages. The COVID-19 pandemic is still prevalent, and its future is uncertain. Having politicians set permanent changes through bills that support telehealth will deter a repeat of the shortages experienced earlier.
References
Medicare, C. M. S. (2020). Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency. Online: Department of Health and Human Services.
Provenzano, D. A., Sitzman, B. T., Florentino, S. A., & Buterbaugh, G. A. (2020). Clinical and economic strategies in outpatient medical care during the COVID-19 pandemic. Regional Anesthesia & Pain Medicine, 45(8), 579-585.
Robeznieks, A., & American Medical Association. (2020). Key changes made to telehealth guidelines to boost COVID-19 care. American Medical Association (AMA).
Weinberger, D. M., Cohen, T., Crawford, F. W., Mostashari, F., Olson, D., Pitzer, V. E., … & Viboud, C. (2020). Estimating the early death toll of COVID-19 in the United States. Medrxiv.
Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., … & Tcheng, J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27(6), 957-962.
Wu, H., Soe, M. M., Konnor, R., Dantes, R., Haass, K., Dudeck, M. A., … & Benin, A. L. (2021). Hospital capacities and shortages of healthcare resources among US hospitals during the coronavirus disease 2019 (COVID-19) pandemic, National Healthcare Safety Network (NHSN), the 27th of March–the 14th of July, 2020. Infection Control & Hospital Epidemiology, 1-4.
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Question 
Telehealth During and After COVID-19
A brief description of a public policy that is having an impact on advanced practice Nurses; summarize your analysis of the procedure using the bulleted list below as a guide. Then, summarize the issue you would like to influence through a change in public policy and outline how you would utilize Kingdon’s Model to guide your policy development.
Healthcare Policy
• Brief Description of Public Policy Having an Impact on My Practice
• Analysis of Policy
• How I would like to Influence the Issue through Public Policy Change
• How Kingdon’s Model would be Used to Guide the Policy Development