After COVID-19 subsides, ‘the telehealth revolution must march on’


It’s hard to find a silver lining in a pandemic. But one of the few may be the rapid rise of telemedicine.

With people stuck at home, doctors retooled their practices to see patients via videoconference. Insurance companies and regulators expanded the number of services available via telemedicine—and made reimbursement for telehealth consultations on par with conventional in-person visits.

The Federal Trade Commission has now called on officials at the Centers for Medicare & Medicaid Services (CMS)  to permanently extend the emergency directives that have allowed telemedicine to take off. That call is the right one.

Wider use of telehealth will reduce costs and improve outcomes for patients everywhere.

Until recently, telehealth was governed by a regulatory framework devised in the internet’s infancy. In a dial-up world, lawmakers couldn’t possibly foresee the coming revolution in telehealth and other technologies. Similarly, the healthcare establishment worried doctors couldn’t conduct quality virtual visits.

States all had their own rules governing the licensure and practice of medicine within their borders. Medicare effectively restricted telemedicine to rural and underserved areas—and did not allow people to receive telehealth care in their own homes.

Congress took a small step forward last year by loosening some telehealth rules in Medicare Advantage plans. But the expansive regulations that burden other Medicare enrollees remained in place.

And then, the pandemic hit, forcing federal officials to bring telehealth into the digital age.

In a matter of weeks, regulators lifted geographic limitations to let patients schedule telehealth appointments across state lines. They waived the arcane and counterproductive rule that required patients to receive telehealth in a medical facility. Privacy waivers let doctors conduct virtual visits over commercial platforms like Zoom and Skype.

In addition to setting telehealth reimbursements at the same level as in-person visits, CMS scrapped a rule that barred doctors from using telehealth to treat patients they hadn’t already seen in person. The agency also expanded the list of telehealth providers eligible for coverage to include physical therapists, audiologists, speech-language pathologists and other vital specialties.

These reforms fueled an astonishingly rapid adoption of telehealth. In March alone, use jumped 4,300% year over year.

Maintaining this new regulatory approach will allow patients to reap telehealth’s many benefits in the years to come. Patients who use telehealth don’t have to drive to the hospital, find parking, check in or sit in the waiting room before seeing a provider. The typical doctor’s visit takes up around two hours of a patient’s time; a typical telehealth call lasts just 15 minutes.

These visits save patients money, too. According to a 2017 study published in Health Affairs, the average telehealth appointment costs $79, compared to $149 for the average office visit.

By making medical visits more convenient and affordable, telehealth could even save lives. Nearly 4 million Americans miss a medical appointment every year because of a lack of transportation. The longer these patients go without care, the higher the odds they’ll succumb to a treatable illness.

Until recently, Nebraska faced a serious “no-show” problem for psychiatric services. The state had about 2 million residents but only 160 practicing psychiatrists, most of whom were concentrated in big cities. Faced with a multi-hour hospital trip, many families living in rural parts of the state chose to forgo care entirely.

To help these patients, the Omaha-based Children’s Hospital and Medical Center established a special telehealth platform for child psychiatric services in 2015. Within years, the program had cut the hospital’s no-show rate for psychiatry patients in half and saved rural families 96,000 miles in annual travel.

We’ve seen the future of healthcare. Virtual visits save time, money and lives. After the COVID-19 outbreak subsides, the telehealth revolution must march on.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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