News Summary
Medicare beneficiaries in San Diego face limited access to telehealth services as temporary benefits expire on October 1, 2023, during an ongoing government shutdown. Healthcare providers are adjusting, with some like UC San Diego Health maintaining services while others, such as Scripps Health, reschedule numerous appointments. Seniors on original Medicare may struggle with telehealth access until a resolution is reached, though those with Medicare Advantage plans appear less impacted. Local responses vary as provider revenue from telehealth appointments is at risk, highlighting the need for immediate legislative action on telehealth benefits.
San Diego, California – Medicare beneficiaries are facing uncertainty in accessing telehealth services following the expiration of temporary telehealth benefits on October 1, 2023, amidst an ongoing government shutdown. This has resulted in significant adjustments by local healthcare providers, as they navigate the impact of this interruption on patient care.
The temporary telehealth benefits were originally granted by Congress in response to the COVID-19 pandemic, allowing medical providers to bill Medicare for online consultations as they would for in-person visits. Although these benefits have been reauthorized yearly since 2020, the current shutdown has hindered the possibility of a new extension.
As a result of the expired benefits, seniors may find their access to telehealth services limited until a new resolution is reached. The situation particularly affects those on original Medicare plans, though those enrolled in Medicare Advantage plans – which account for about half of the 69 million Medicare beneficiaries – are not automatically impacted by the shutdown. In San Diego County alone, there are approximately 327,000 individuals enrolled in Medicare.
Local Provider Responses
A survey conducted among healthcare providers in the San Diego region revealed a variety of strategies employed to maintain access to telehealth services. Many providers indicated they were able to keep telehealth appointments available for patients. For instance, UC San Diego Health confirmed it has maintained all telehealth appointments, but there is a possibility of implementing restrictions if the shutdown continues.
On the other hand, Scripps Health has already had to reschedule several hundred telehealth appointments, directing some Medicare beneficiaries to attend in-person visits instead. In the timeframe from October 1 to a specified Monday, Scripps reported that 435 telehealth appointments were rescheduled to in-person consultations. However, 642 patients managed to retain their telehealth appointments through Scripps’ Accountable Care Organization.
Kaiser Permanente, which primarily serves its Medicare patients through Advantage plans that remain unaffected by the shutdown, is able to continue offering digital consultations. Additionally, patients on original Medicare who have supplemental “Medigap” plans can continue accessing telehealth services.
Impact on Patients and Healthcare Providers
Despite the changes, some Medicare patients opted to keep their scheduled telehealth appointments even if aware that these visits might not be covered by Medicare, potentially leaving them responsible for the costs. Providers like Sharp Healthcare are continuing to offer telemedicine services through their Accountable Care Organization, recognizing the importance and convenience of these services for patients.
One urologist at UC San Diego Health indicated that eliminating the ability to bill Medicare for telehealth services could substantially impact the revenue of healthcare providers, as telehealth visits make up 18-20% of their daily patient encounters. The organization hopes for short-term claims processing of services provided during the shutdown.
Healthcare Outcomes and Future Developments
Research from UC San Diego has shown that a telemedicine clinic designed for high-risk patients resulted in fewer readmissions. Patients who engaged with the telemedicine services had a 30-day readmission rate of 14.9%, compared to 20.1% in a benchmark group receiving standard follow-up care. The study evaluated over 25,000 participants, indicating the potential effectiveness and efficiency of telehealth for patient care.
As discussions about future telehealth legislation continue, it’s important to note that a new California law going into effect on January 1 will allow veterinarians to prescribe medication via video calls under specified conditions, paralleling the existing telehealth benefits for human patients. The law also requires that emergency shelters provide accommodations for pets, reflecting a wider commitment to inclusive healthcare access.
Deeper Dive: News & Info About This Topic
HERE Resources
California Rural Hospitals at Risk of Closure
Additional Resources
- San Diego Union Tribune: Medical Providers and Telehealth
- Wikipedia: Telehealth
- Times of San Diego: UCSD Telemedicine Study
- Google Search: Telehealth
- OC Register: Telehealth Licensing Issues
- Google Scholar: Telehealth Impact
- NBC San Diego: New Law for Pet Telehealth
- Encyclopedia Britannica: Telemedicine
- Healio: Penicillin Allergy Telehealth Consultation
- Google News: Health Care
Author: STAFF HERE SAN DIEGO WRITER
SAN DIEGO STAFF WRITER The SAN DIEGO STAFF WRITER represents the experienced team at HERESanDiego.com, your go-to source for actionable local news and information in San Diego, San Diego County, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as Comic-Con International, San Diego County Fair, and San Diego Pride Festival. Our coverage extends to key organizations like the San Diego Regional Chamber of Commerce and United Way of San Diego County, plus leading businesses in biotechnology, healthcare, and technology that power the local economy such as Qualcomm, Illumina, and Scripps Health. As part of the broader HERE network, including HEREAnaheim.com, HEREBeverlyHills.com, HERECostaMesa.com, HERECoronado.com, HEREHollywood.com, HEREHuntingtonBeach.com, HERELongBeach.com, HERELosAngeles.com, HEREMissionViejo.com, and HERESantaAna.com, we provide comprehensive, credible insights into California's dynamic landscape.
