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Clock Ticking for Telehealth?

Clock Ticking for Telehealth?

Expanded telehealth has lowered costs and expanded access for millions of Americans—but it will disappear when the pandemic is over unless we make it permanent. Action Alert!

Many Americans have benefitted from expanded access to telehealth during the pandemic that helps reduce the cost of medical care, but this expanded access will disappear once the pandemic is over. There are several bills in Congress that seek to make permanent changes in the rules to allow more access to telehealth. Expanded access to telehealth offers an opportunity to lower healthcare costs; we must support these bills!

Telehealth access is important to maintain because it helps reduce the cost of healthcare. One recent study found that the average telehealth patients’ health care costs fell 61%, from $1,099 per month to $425 per month, between January 2020 and February 2021. This is likely because the average primary care visit averages between $100 and $150. A telehealth visit costs about $40.

There are other benefits. Telehealth saves patients time commuting and sitting in waiting rooms, and for patients with chronic conditions that require many appointments, this is a big deal. Evidence demonstrates that telehealth is beneficial for patients with cardiovascular disease, diabetes, and depression.

Before the pandemic, regulators and lawmakers intentionally made it difficult for Americans to take advantage of the lower costs of telehealth, fearing widespread telehealth use would lead to more spending on unnecessary health care. Medicare, which often sets the tone for insurers across the country, banned clinicians from delivering telehealth outside of rural areas and prohibited patients from receiving telehealth within their homes.

This changed during the pandemic when telehealth allowed greater access to physicians when patients were wary of in-person visits. The public health emergency allowed government regulators to relax a number of restrictions on telehealth services. Pre-pandemic, for example, Medicare would only reimburse for telehealth services in rural areas, and the patient needed to go to a medical facility to receive service—they couldn’t stay at home.

Additionally, there were previously restrictions on where the practitioner could be during the time of the telehealth service. If physicians were dispensing telehealth services while at rural health clinics or federally qualified health centers (FQHCs), which predominantly service disadvantaged communities, they could not get reimbursed from Medicare or Medicaid. These restrictions, too, were relaxed during the pandemic. This has improved health care access for historically marginalized populations. Racial and ethnic minorities are 1.5 to 2 times as likely to suffer from a chronic disease as whites; expanded telehealth can help improve the health of these populations.

Loosening these restrictions led to an explosion of telehealth usage, which increased from 134,000 to 10.1 million people using telehealth in the first six months of 2020.

The problem is that, once the public health emergency ends, these relaxed rules will disappear. A number of bills in Congress seek to make a number of these changes permanent. The Telehealth Modernization Act, the CONNECT Act, and the Protecting Rural Telehealth Access Act. Together, these bills would:

  • permanently allow Medicare enrollees to receive telehealth services at home;
  • expand the practitioners who can furnish telehealth services (such as physical therapists);
  • waive restrictions on the types of technology that may be used;
  • permanently allow rural health clinics and FQHCs to serve as distance sites for providing telehealth services.

We also reported previously about state-level efforts to mandate that insurers reimburse for telemedicine at the same rate as in-person visits (called payment parity). These crony price-fixing schemes are designed to thwart competition and keep healthcare costs high. Currently, 29 states have telehealth payment parity laws.

The US spends significantly more money on healthcare than any other industrialized country. There are many reasons for this, but we must embrace policies like expanded telehealth access that give patients cost-saving options.

Action Alert! Write to Congress and tell them to support bills that expand telehealth access! Please send your message immediately.

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