{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:28:23Z","timestamp":1761006503629,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Ample literature shows voice and swallowing therapy, in\u2010person or virtual, to be essential for Otolaryngology and Speech\u2010Language Pathology care. In March 2023, Medicare announced discontinuing teletherapy reimbursement in hospital\u2010based outpatient departments, effective May 2023. This decision was subsequently reversed; however, the uncertain interval period provided the opportunity to study the impact of eliminating teletherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary laryngology center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Affected Medicare patients were contacted via mailed letter, phone, and secure patient portal and offered to change appointments to in\u2010person, teletherapy with cash self\u2010payment ($165\u2010282\/session) or cancellation. Demographics and responses were collected. Statistical analyses conducted using Student's <jats:italic>t<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010three patients (28 female; mean age 66.8\u2009\u00b1\u200914.2 years) were impacted. 64% (n\u2009=\u200934) changed to in\u2010person appointment, 28% (n\u2009=\u200915) canceled, 8% (n\u2009=\u20094) did not respond. No patients opted to self\u2010pay. 67% of patients that canceled telehealth care cited distance from in\u2010person care location. The mean distance for canceled versus rescheduled patients was 92.3\u2009\u00b1\u200993.0 versus 32.8\u2009\u00b1\u200957.4 miles, <jats:italic>P<\/jats:italic>\u2009=\u2009.034. Mean age, gender, and number of sessions were not different between groups. Mean time to third next available therapy appointment was 96\u2009\u00b1\u200946 versus 46\u2009\u00b1\u200912\u2009days before and after rule change, <jats:italic>P<\/jats:italic>\u2009=\u2009.007. Upon Medicare's reversal, this trend rebounded to nearly baseline (mean 77\u2009\u00b1\u200912 days, <jats:italic>P<\/jats:italic>\u2009=\u2009.12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Medicare's discontinuation of reimbursement for teletherapy services caused nearly 30% of patients to cancel voice and swallowing therapy, primarily due to distance. These cancellations led to decreased access to care for Medicare patients with voice\/swallowing diagnoses, which affect function, quality of life, and potentially even mortality risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.779","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T02:43:30Z","timestamp":1712976210000},"page":"425-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medicare Restriction of Telehealth Speech Services Negatively Impacts Patient Care"],"prefix":"10.1002","volume":"171","author":[{"given":"VyVy N.","family":"Young","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco Voice and Swallowing Center San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco Voice and Swallowing Center San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco Voice and Swallowing Center San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco Voice and Swallowing Center San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.064337"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1044\/2015_AJSLP-14-0120"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.08.020"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13596"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2023.2215488"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27356"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2019.07.025"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208843"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198306303082605"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25155"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07719-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1044\/2022_AJSLP-21-00342"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2023.03.001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1742195"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29321"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_PERSP-19-00146"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa067"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24706"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.12.003"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.08.007"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2008.0040"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894231165811"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2022.07.009"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29838"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820932167"},{"key":"e_1_2_8_27_1","unstructured":"Medicare telemedicine healthcare provider fact sheet. 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