Opinions in Healthcare

The Explosion of Telehealth in Healthcare

  • Due to COVID-19 and the practice of social distancing, the surge of telehealth/telemedicine increased more than what was expected.

  • Federal and state telehealth policy changes were to help accommodate as many people as possible. Many changes were made, such as HIPAA laws being more relaxed as technology platforms were being used to allow medications to be prescribed to patients without physical contact with their healthcare provider.

  • This also helped pave the way for healthcare professionals to practice across state lines under their license from their home state.

Telehealth’s Sudden Rise

  • The expansion of telehealth was propelled by the necessity of seeking health care providers without leaving their homes due to state and federal agencies losing restrictions on telehealth medicine and expanded eligible codes for reimbursement, as well as eligible locations and types of providers.
  • The first announcement on COVID-related telehealth policy changes came on March 17th, 2020, under the Coronavirus Preparedness and Response Supplemental Appropriations Act.
  • Before COVID-19, Medicare primarily covered telehealth services for beneficiaries living in rural areas, where there were far fewer medical providers, and patients were required to travel to designated sites, such as clinics or hospitals, to receive telehealth.
  • Outside of rural areas, all health professionals who were eligible to bill Medicare could now deliver their services via telehealth (including physical therapists, speech-language pathologists, and occupational therapists).

The Impact of Telehealth Post-COVID

  • The significant expansion of telehealth disproportionately increased access to care in urban communities. In 2021, more than one-third of Americans (37%) lived in areas with shortages of mental health professionals.
  • As for the quality of care, early evidence suggests that services delivered through telehealth can be equivalent to in-person care for managing chronic diseases and treating behavioral health issues.
  • Because of telehealth’s ability to make care more accessible, the Congressional Budget Office (CBO) has historically projected that expansions in telehealth will increase healthcare spending; however, an individual’s clinical condition as well as how virtual care is being used by a provider are both key factors in determining the balance of substitutive versus additive care.

Telehealth Expansion Act

  • The passing of the Telehealth Expansion Act of 2023 shows the federal government’s commitment to health equity. This shows the importance of increasing access to quality healthcare for all citizens, regardless of location or socioeconomic status.
  • This is a bipartisan bill recently passed in Congress. It allows all citizens who have high-deductible health plans and health savings accounts access to telehealth and other remote care services permanently, without having to meet their minimum deductible first.
  • The bill makes permanent telehealth flexibilities that were first introduced in the CARES Act of 2020.
  • It also allows for health plans and employers to cover telehealth visits for individuals with high-deductible health plans and health savings accounts, providing families with a lot of flexibility to maintain access to a range of affordable virtual care services before the deductible is met.

Resources

https://bipartisanpolicy.org/report/future-of-telehealth/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013549/

https://www.healthcareitnews.com/news/what-telehealth-expansion-act-means-tackling-social-determinants-and-boosting-health-equity#:~:text=The%20passing%20of%20the%20Telehealth,of%20location%20or%20socioeconomic%20status.

Melissa Alex, PharmD Candidate 2024