Telehealth- A Statement from the Clinical Exercise Physiology Association
23 May 2020
The COVID-19 pandemic has placed an unprecedented strain on individuals, families, medical institutions, healthcare providers, the economy and society. Leaders have called upon citizens to practice social distancing, frequent hand washing and staying-at-home with the provision of leaving one’s residence only for essential errands in an effort to mitigate the spread of the aggressive virus. As a part of these efforts, outpatient services have mostly been suspended, with the exception of emergent cases. Although medical attention has globally shifted to diagnosing, treating and caring for COVID-19 positive patients, the healthcare demands of patients with chronic conditions have certainly not slowed. In recognition of the newly imposed barriers, Centers of Medicare and Medicaid Services (CMS) have approved reimbursement for certain telehealth services to distantly care for patients to help avoid health exacerbations that require in-clinic care. While various physical rehabilitative services, such as those provided by Physical or Occupational Therapists are covered, cardiac and pulmonary rehabilitation (CR/PR) services have been overlooked. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recently submitted a proposal seeking temporary reimbursement for outpatient telehealth services, which was ultimately rejected by CMS.
CR and PR services have been empirically shown to improve overall health, quality of life and reduce the financial burdens imposed upon the healthcare system by reducing rehospitalization and the need for advanced surgical procedures. A growing body of literature demonstrates comparable health improvements between telerehabilitation and traditional center-based CR/PR. Without CMS reimbursement for these services, many CR and PR programs have redirected employee efforts to other units within their health institution. Consequently, cardiac and pulmonary patients are not receiving professional guided exercise and health educational services, which may result in patients living a highly inactive lifestyle due stay at home orders.
Regular exercise elicits profound cardiopulmonary, skeletal muscle, psychosocial, metabolic and immune system benefits. All of which are critical for cardiac and pulmonary patients who are at a high risk for experiencing serious health complications associated with COVID-19 infection. It is imperative that CMS recognize the comprehensive health benefits that can be achieved through the delivery of exercise telerehabilitation services and approve reimbursement so that practitioners can provide CR and PR services to patients during this time of isolation. The Clinical Exercise Physiology Association will continue to fully support AACVPR’s reimbursement efforts and passionately advocate for clinical exercise physiologists.