UPMC Health Plan
Pittsburgh (August 14, 2020) – As part of a select group of health insurance leaders invited to participate this week in a White House Office of Science and Technology “Executive Roundtable on Telehealth,” UPMC Health Plan President & CEO Diane Holder shared UPMC decades-long commitment to providing Telehealth services to members in all of the health plans it offers needing timely access to behavioral and physical care and treatment.
"UPMC has been providing Telehealth services for over 25 years, but with the recent COVID-19 pandemic, the volume of Telehealth services increased dramatically,” said Holder. “UPMC Health Plan members have been provided at least two million Telehealth visits since the pandemic began.” According to Holder, it is a critical service for Health Plan members, particularly families with young children, seniors, special needs populations, and people managing chronic conditions, to stay engaged with their health care providers.
During the discussion, moderated by Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verna, Holder said: “UPMC Health Plan appreciates the opportunity to be one of a handful of health insurers asked to participate in this productive policy discussion. Thanks to the flexibility provided by CMS, we’ve seen exponential growth in Telehealth use across all services. Telehealth makes it possible to improve access for our members to receive care in the safety and convenience of their home or workplace to ensure that important clinical services are available to stay healthy or avoid unnecessary deterioration of a serious condition.”
Both before and during the current public health emergency, UPMC Health Plan has worked to expand coverage of Telehealth services. Prior to the current public health emergency, Telehealth benefits included at least 170 different health care services from a range of providers. COVID-19 prompted the Health Plan to further expand coverage to include over 100 additional services, like physical and occupational therapy, as well as audio-only visits for a range of conditions and providers. These expanded services give particular focus to critical services and supports, like behavioral health and counseling, that allow patients to remain safely at home.
UPMC Health Plan joined the group in supporting the Pledge to Embrace Technology to Advance America’s Health. Holder said she hoped the shared effort could build support for additional reforms that are necessary to facilitate continued growth and evolution of Telehealth options to help increase safe, necessary access to behavioral health services, including Medication Assisted Treatment (MAT) for opioid and other substance use disorders.
One of the most important areas where Telehealth needs to evolve is in the delivery of behavioral health services, especially related to providing MAT to those who need it but may not have immediate access to an initial in-person appointment. Given the practical potential of Telehealth to make timely substance use disorder services available in communities that may otherwise struggle with access, current requirements for in-person exams prior to the initiation of MAT (due to restrictions on buprenorphine and related medications as a controlled substance) represent a barrier to the integration of telehealth into substance use disorder treatment. While recognizing the inherent risks that the in-person examination requirement is intended to mitigate, insurers should have flexibility to waive this requirement for known providers with appropriate oversight. Initial analysis of Telehealth utilization during the public health emergency shows increased care adherence on MAT programs from patients who can now access Telehealth.
The expansion advocated by UPMC Health Plan is particularly important for rural areas. Physicians can use Telehealth to service a larger geographic area, and thereby multiply their capacity to responsibly treat individuals who need MAT as part of a recovery treatment plan. UPMC Health Plan supports bipartisan federal legislation, S. 4103, the Telehealth Response for E-Prescribing Addiction Therapies (TREATS) Act as a potential vehicle to address these changes, as well as regulatory actions.
About UPMC Insurance Services
Serving more than 3.9 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life CompleteCare and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids). Community Care Behavioral Health, one of the nation's largest managed care behavioral health organizations, offers a full range of services to Commercial and Medical Assistance members. For more information, visit www.upmchealthplan.com.