Table 2.

Recommendations for Incorporating Enhanced Telemedicine in Long-Term Care Practice After the COVID-19 Pandemic

Recommendation	Action
Regulatory reform	•Allow Medicare payments to post-acute and long-term care clinicians for all skilled/nursing facility CPT E&M codes using telehealth •Allow medical necessity to dictate telemedicine visit frequency for subsequent care visits •Allow nursing homes to receive facility fees for all telemedicine encounters regardless of physical location •Expand billable telemedicine services for nursing home residents to include e-consultation and additional remote patient monitoring •Ensure payment parity between face-to-face and telemedicine care in Medicare and third-party payors
Evaluate the impact of telemedicine on nursing home structure, process, and outcomes	•Develop and assess the impact of PALTC workforce competencies for both originating and distal site providers who use telemedicine tools on clinical outcomes •Refine and assess the use of telemedicine for forward triage on clinical outcomes •Evaluate how regulatory visits delivered by telemedicine vs face-to-face impact the quality of clinical care and provider or resident satisfaction
Technology	•Collaborate with telemedicine service providers to develop cost-effective, low-bandwidth, accessible, and easy-to-use telemedicine technology •Work with cellular service and Internet service providers to deliver high-speed, low-cost Internet access, to support telemedicine and communication technologies in nursing homes •Collaborate with electronic medical record vendors to improve access to and documentation within various information systems during telemedicine visits •Increase the number of easy-to-use, low-cost Health Insurance Portability and Accountability Act (HIPAA) security–compliant telemedicine tools available to post-acute and long-term care providers.

CPT, Current Procedural Terminology; E&M, evaluation and management.