Maturity Model
The Maturity Model provides high-level guidance for advancing telehealth capabilities. It’s the “what” we hope to achieve. This is the model for Reimbursement & Policy; view the full Maturity Model.
| Sustainability Curve 1: Covid-19 Response | Sustainability Curve 2: CARE INTEGRATION | Sustainability Curve 3: EXPANSION & SUSTAINABILITY |
|---|---|---|
| Liberal to support COVID-19 delivery of care | FFS reimbursement supports phone and video; partial patient enablement support; HRSA, FTCA, other regulatory flexibilities | Sustainable reimbursement HRSA modernization |
Drivers of Success
The Drivers of Success represent “how” to improve performance. These are the drivers for Reimbursement & Policy; view the full Driver Diagram.
- Expanded reimbursement guidelines at state and federal levels
- Advocacy for HRSA and other regulatory agencies to support sustainability
Expanded Reimbursement Guidelines
The COVID-19 crisis led to a rapid expansion of telehealth reimbursement. Reimbursement policies continue to evolve, and differ across state lines.
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Telehealth Reimbursement Tip Sheet
Current billing and reimbursement expectations for Medicaid, MassHealth, and commercial payers, including waived services during the Public Health Emergency (PHE).
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Center for Connected Health Policy
CCHP actively researches and analyzes important telehealth policy issues and provides key telehealth policy resources nationwide.
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MassHealth Provider Bulletins
MassHealth issues provider bulletins as needed to communicate procedures, reminders, and other information to MassHealth providers.
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CMS Telehealth Information
Information about telehealth from the Centers for Medicare and Medicaid Services
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Advocacy to Support Sustainability
For health centers to be positioned well for sustained reimbursement and support for telehealth, leaders will need to focus on the following tactics, in partnership with their state’s Primary Care Association:
- Monitor closely the developments in industry, policy, and reimbursement that will or may impact telehealth goals
- Measure visit access, patient satisfaction, and equity with telehealth to support advocacy
- Capitalize on expanded reimbursement guidelines and build sustainable billing processes for all appropriate care team members
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MassHealth Telephone & Internet Connectivity for Telehealth
A resource from MassHealth to help providers guide members who have questions about engaging in services through telehealth
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