Press Release  HPC ISSUES REPORT ON SUCCESSFUL EXPANSION OF TELEHEALTH USE IN THE COMMONWEALTH; RECOMMENDS POLICIES TO IMPROVE ACCESS, EQUITY, AND COST-SAVINGS IN VIRTUAL CARE

BOSTON — Today, the Massachusetts Health Policy Commission (HPC) held its first public meeting of 2023 and released a new legislatively mandated report on telehealth in the Commonwealth. The HPC outlined its 2023 policy priorities and activities and previewed two upcoming publications on the impact of COVID-19 on the health care workforce and factors impacting disparities in health care. The HPC’s Board also welcomed three new commissioners – primary care physician and City of Worcester Commissioner for Health and Human Services Dr. Matilde Castiel, Administration and Finance Secretary Matthew Gorzkowicz, and Acting Health and Human Services Secretary Mary Beckman, established new committee membership, and voted to re-appoint Commissioner Martin Cohen as Vice Chair. Commissioners also voted to issue a proposed update to the Office of Patient Protection’s (OPP) regulation on health insurance consumer protection and closed out the 2022 Performance Improvement Plan (PIP) review cycle. The meeting concluded with a video presentation reflecting on the HPC’s 10-year anniversary milestone. A full recording of the meeting and presentation materials can be found here.

Report to the Legislature: Telehealth Use in the Commonwealth and Policy Recommendations

In January 2021, the Massachusetts Legislature passed Chapter 260, An Act Promoting a Resilient Health Care System that Puts Patients First, which directed the HPC to conduct a study on telehealth use in Massachusetts and provide policy recommendations on reimbursement levels and strategies to expand access to telehealth in the Commonwealth.

Key Findings

• In 2020, 31% of all ambulatory visits in Massachusetts – and 65.6% of mental health visits – were conducted via telehealth with 53.5% of all commercial members making use of telehealth for at least one visit.
• Telehealth use was higher for patients with more chronic conditions, in more urban communities, and those with better internet access. There were minimal differences by community income level.
• The HPC found that expanded telehealth use did not increase total spending, while the availability of telehealth appears to have improved access to mental health care.

Policy Recommendations

The HPC report includes recommendations to improve patient access and quality of care while maximizing the cost-saving potential of telehealth. The HPC urges the Legislature to prioritize three actions regarding the billing and payment of telehealth services:

• Extend Payment Parity for Certain High-Value Telehealth Services. The Commonwealth should extend the sunset for the payment parity mandate on a limited basis (e.g., for two years) for primary care and chronic disease management. The additional time would allow providers to continue improving their telehealth platforms and workflow, and to develop efficient hybrid care models that take advantage of the lower resource needs for some telehealth visits relative to in-person visits.
• Prohibit Unnecessary Hospital Fees. Consistent with the HPC’s long-standing recommendation to limit facility fees for certain common ambulatory services in hospital outpatient departments, the Commonwealth should prohibit providers from charging facility fees for telehealth services to improve market fairness and consumer protections.
• Reduce Telehealth Billing Complexity. Consistent with the HPC’s previous recommendation on administrative complexity, coding rules and documentation requirements for telehealth services should be standardized across payers – including audio-only services – to reduce unnecessary administrative complexity in the health care system and their associated costs.

“The increased use of telehealth in Massachusetts since the beginning of the COVID-19 pandemic has been a tremendous success, improving patient access to needed care, especially for mental health services,” said David Seltz, HPC Executive Director. “As a next step, we must work to ensure equitable telehealth access across all communities and realize potential cost savings for the Commonwealth. Through the continued support and innovation from our health plans and providers, Massachusetts can be a national leader in virtual care.”

A copy of the full report, including additional recommendations on access to care, health equity, and consumer transparency can be found here.

2023 Policy Priorities and Activities

To kick off 2023, the HPC is pursuing an ambitious action plan to reduce health care cost growth, promote affordability, and advance equity. The agency will prioritize disseminating data-driven insights and policy recommendations to address the critical challenges facing the health care system today, including the workforce crisis, high costs, and persistent health inequities.​

1. Bolster the HPC’s Cost Containment Activities​. The HPC will work with the Healey-Driscoll Administration and Legislature to expand levers for cost control as described in the HPC’s 2022 Health Care Cost Trends Report. Other focus areas include continued scrutiny of payer and provider spending performance and provider market changes, and continued collaboration with other states on how to optimize the impact of health care cost growth targets and implement complementary strategies to reduce spending growth.​
2. Address Health Care Workforce Challenges and Identify Solutions. Specific areas of focus include a new HPC report and recommendations on workforce challenges and solutions in Massachusetts, holding a special event to convene stakeholders to discuss workforce challenges and recommended solutions, and continuing to support and promote innovative care models that leverage non-traditional and complementary health care workers (e.g., doulas, recovery coaches, community health workers).
3. Advance Health Equity. Specific areas of focus include a new HPC report on how health system factors perpetuate disparities, strengthening health equity standards within the ACO Certification Program, designing new HPC grant opportunities to reduce identified disparities or otherwise advance equity, and evaluating staff needs to support HPC health equity work.
4. Enhance Pharmaceutical Pricing Transparency and Accountability​. The HPC will collaborate with MassHealth on the drug pricing review process to support their supplemental rebate negotiations. The HPC will also research and present on areas such as prescription drug prices in Massachusetts as compared to international pricing, the impact of implementing copay caps for certain drugs, and the impact of high spending outpatient drugs on spending and price trends.
5. Reduce Unnecessary Administrative Complexity. Specific areas of focus include partnering with stakeholders and the Network for Excellence in Health Innovation (NEHI) to promote prior authorization automation, identifying other priority areas for streamlining, simplification, or standardization and convene stakeholders to develop and advance solutions, and continuing staff support and policy leadership of the Quality Measurement Alignment Taskforce (QMAT).
6. Upcoming Topics of Actionable Research​. The HPC will issue new policy papers on the consolidation of the pediatric health care market in Massachusetts and the options and implications for capping provider prices. The HPC will also research and investigate the impact of risk adjustment on spending trends and the role of private equity investments in Massachusetts health care.

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