Telemedicine goes mainstream

The coronavirus pandemic has ushered in a new era and level of acceptance for telemedicine and telehealth.¹ The medical community, spurred by necessity and consumer demand, is increasingly embracing the inherent efficiencies and public health safety precautions that are available to practitioners and consumers of remote medicine. All 50 states have issued bulletins, executive orders, and notices urging and, in some cases, requiring insurers to accept and broaden access to telehealth programs and plans to cover the costs. Numerous states’ directives require pay parity, a longstanding deterrent, for reimbursements of healthcare services rendered via telemedicine at the same rate as in-person services.² Regulators have also expanded telemedicine to include a much broader range of technologies for the delivery of services, including by phone, audio/video, secure text messages, email, or a direct patient portal.³

Since the onset of the COVID-19 pandemic, many states expanded coverage and availability of telehealth services to limit spread of the disease and expand access to healthcare. In March 2020, Medicare began allowing all enrollees to use telemedicine, an option previously available only to those in remote areas or for short, specific visits. Additionally, physicians were granted reciprocity to provide telemedicine services to Medicare patients across state lines. Some states, including Missouri and Pennsylvania, also allowed physicians licensed outside the state to provide telemedicine care more easily. Idaho, Colorado, and others allowed providers to use non-HIPAA-compliant technologies in certain circumstances. Many states required insurers (VT, IA, AZ) to reimburse telehealth services at the same rate as in-person services (i.e., payment parity). Several states have also limited or reduced to zero the amount state-regulated insurers may charge in consumer cost sharing for telehealth services during the pandemic. Healthcare systems also worked to enhance access to telemedicine services by increasing physician availability and waiving copays for the duration of the pandemic.⁴

Since COVID-19 became a national health emergency, the landscape for telehealth has shifted dramatically and will likely continue to shift as healthcare needs increase over time. Telehealth proponents have advocated many years for the kind of approach being taken to virtual care observed currently. Relaxing originating site requirements so that patients may be treated where they are located, increasing the services covered under government programs, requiring payment parity, expanding the acceptable modalities to include the technology most convenient for care, and foregoing the in-office visit requirement for the prescribing of controlled substances are all advances telehealth advocates have been championing for decades.⁵