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In a new report, the Office of Inspector General (OIG) of the US Department of Health and Human Services (HHS) found that home health agency (HHA) services should be reviewed to improve emergency preparedness. During COVID-19, the Centers for Medicare & Medicaid Services (CMS) facilitated the use of telehealth services through regulatory flexibility and expanded telehealth allowances. Although these measures helped, staffing challenges persisted throughout the emergency.
To better understand the role of telehealth and other emergency responses during COVID, the OIG surveyed a sample of 400 HHAs in the fall of 2021. Staff members at HHAs were also interviewed regarding their experience providing care during the pandemic.
Home-Health Telehealth Professionals Faced Obstacles
- Agencies encountered various obstacles in deploying home health telehealth in the early phases of the emergency. There were accessibility challenges associated with technology, equipment, and phone service coverage. Some remote communities had low resources, making acquiring the essential equipment for telehealth services challenging. The majority of HHAs surveyed cited inadequate Internet access as a hindrance.
- Although HHAs benefited from government support such as paid leave, which helped them manage some of the staffing problems, these methods fell short of properly delivering telehealth care, which raises questions about its future role. Forty-three percent of HHAs that used home health telehealth reported that they would not use it again.
- The home health telehealth reporting requirements were minimal and fell short of collecting the needed information. Due to this lack of reporting, analysis of telehealth services provided during the epidemic yielded minimal findings.
OIG Recommends Three Home-Health Telehealth Measures for CMS
The report requests that CMS take advantage of the data collected during COVID to investigate how HHAs used home health telehealth to assess how to best help HHAs prepare for and respond to future emergencies. It also suggests that CMS evaluate how home health can better serve patients.
- The OIG recommended that CMS investigate the types of patients who benefit the most from telehealth.
- The OIG also requested that HHAs reevaluate the effect of regulatory flexibilities regarding telehealth affecting the quality of home healthcare during COVID-19.
- To better prepare for potential future disasters by learning from the recent pandemic experience, the OIG also recommended that CMS work with the Administration for Strategic Preparedness and Response’s (ASPR’s) Technical Resources, Assistance Center, and Information Exchange (TRACIE).
CMS agreed to all three recommendations.
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