While the negative consequences of the COVID-19 pandemic are too numerous to count, there has been at least one bright spot in this unfortunate episode — telehealth's widespread adoption.
Since the beginning of the pandemic, more Americans have received care remotely than ever before. That trend has been helped along by a long list of state and federal waivers aimed at reducing regulatory barriers to accessing — and practicing — telemedicine.
Unfortunately, many of those waivers have expired or will do so in the near future.
By renewing these waivers — or ideally, making them permanent — regulators in Washington, D.C. and in state capitals can ensure that our new age of telemedicine doesn't end prematurely.
The speed with which telehealth caught on during the pandemic has been remarkable. Consider a new report by the U.S. Department of Health and Human Services, which found that telehealth use among Medicare fee-for-service beneficiaries increased 63 times over in 2020 relative to the previous year.
Telehealth's newfound popularity wasn't limited to Medicare. According to an analysis by the consulting firm McKinsey, overall telehealth utilization is now 38 times higher than it was before the pandemic.
In the case of Medicare, this increase in remote care was made possible by a number of federal waivers. These reforms allowed seniors who lived in urban areas to make use of telehealth — an option previously only available to rural residents.
They also permitted Medicare beneficiaries to receive telehealth services from their homes instead of having to travel to a clinical facility. Often Medicare patients do not have cars for traveling to a facility, and that facility may be a long distance from their homes.
In order to accommodate patients without access to a computer or camera, restrictions on audio-only telehealth services were also lifted.
Many states passed their own telehealth waivers during this period, too.
Physicians were allowed to practice remotely in many states even though they weren't licensed there. States also adopted payment-parity reforms, which ensured that telehealth visits would be reimbursed at the same rate as in-person visits.
Equally significant was the decision of many insurers to waive copays on telehealth services during the pandemic. In most cases, these policies were intended to last only as long as a public health state of emergency remained in place. Some have expired.
Moreover, several private insurers have reinstated cost-sharing for telehealth visits.
But there's no reason why telehealth should be reserved for crises like COVID-19.
We should instead be asking why there were so many telehealth restrictions on the books to begin with. These technologies make it easier for patients to receive timely, high-quality care.
They also give hospitals real-time access to specialists that may be thousands of miles away. And they enable physicians to make more effective use of their time at a moment when doctors are in short supply.
Making telehealth waivers permanent would only expand access to care.
To their credit, many states are already moving in that direction.
At last count, 18 states have passed laws requiring payment parity for telehealth. For its part, HHS has extended Medicare's telehealth waivers through December of 2023.
Nevertheless, the future of telehealth remains far from clear.
The rest of the states, as well as the District of Columbia, have no active telehealth waivers in place, according to the Federation of State Medical Boards.
Such a patchwork of restrictions, permanent waivers, and waiver extensions could prove disastrous for the future of telehealth. Without more regulatory certainty, many providers will remain hesitant to expand their telehealth offerings.
Telehealth start-ups, meanwhile, will have a more difficult time attracting investment.
This promising approach to care may take far longer than necessary to meet its potential.
The last two years have made the benefits of telehealth undeniable. It's time for policymakers to wake up to this fact — and permanently eliminate the telehealth restrictions that, in retrospect, never should have existed in the first place.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
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