Legislation to expand access to telehealth services is likely to pass Congress this year. But what exactly will it entail?
Policymakers agree they need to extend the waivers that made the rapid expansion of telehealth during the pandemic possible. They remain divided, however, about the duration of those waivers.
The Telehealth Extension and Evaluation Act, for example, calls for only a two-year extension of all waivers. This would allow time for a study of telehealth service delivery that gives policymakers more information before making telehealth permanent.
In contrast, the Telehealth Extension Act would permanently remove certain site-based and geographic restrictions that limit where patients can receive services. The bill’s sponsors say there is already broad support from medical experts and patient advocates to eliminate them.
The legislation recognizes that some services may require in-person care. For example, in-person appointments would be required for patients receiving high-cost durable medical equipment or major laboratory tests. And, in the name of fraud protection, federal officials would be able to audit physicians.
A Patient-Centered Approach
Regardless of which legislation ends up moving forward, it’s important for policymakers to approach the issue from a patient-centered perspective. Telehealth is a valuable complement to in-person care, not a substitute for it. With this goal in mind, the ideal telehealth policy would:
- Create payment parity so providers get paid the same whether they see patients in-person or via telehealth
- Ensure policies to not limit the ability to get in-person care
- Allow providers to see patients across state lines, which reduces patients’ travel burden
- Ensure “low-tech” audio only visits are allowable and paid at the same rate as an appointment with audio and video connection
- Support the infrastructure necessary to get more Americans access to the broadband internet that allows “high-tech” telehealth visits.
Expanding Access to Broadband
This last issue – addressing access to high-speed internet – has long been a problem, but the pandemic laid bare how America’s digital divide affects access to equitable health care.
Nearly a quarter of Americans still don’t have high-speed internet at home, though there are movements afoot for insurers to pay for broadband access as a health-related cost. Select plans at both the federal and state levels as well as some private insurers now treat high-speed internet as a covered benefit.
While the Biden administration is pushing for expanded broadband connections, it’s also pledged to take a closer look at the effectiveness of telehealth in serving all Americans. The White House Office of Science and Technology Policy launched a series of roundtable discussions examining which pandemic-driven telehealth innovations are worth keeping and which might reinforce existing disparities in access to health care and technology.
There are still many questions to be answered about the long-term role of telehealth. But momentum for expanded telehealth services is clearly building. If done correctly, policy changes should bode well for Americans’ health.
