States can make a difference in long-term telehealth policies
The National Governors Association released a white paper this week examining state policies around telehealth and outlining key considerations for governors to assess the potential implications of said policies going forward.
As the report notes, although policies vary from state to state, there have been more telehealth policy changes this year than in the past two decades, with a dramatic uptick in virtual care services to match. As of last week, telehealth legislation extending beyond the pandemic has been passed in 23 states.
"While we cannot assume that the higher uptake of telehealth will continue at the same rate post-pandemic, as patients may have felt they had little choice but to receive services virtually, payers are amassing extensive data upon which to measure outcomes in the short and long-term," the report read.
WHY IT MATTERS
The report offered several key considerations for governors with regard to telehealth policies, including with regard to:
- Pairing payment models and incentives
- Narrowing the digital divide
- Interoperability of platforms
- Privacy protections
- Engaging stakeholders
The matter of licensure is a particularly notable one, given that state legislators and licensing boards are primarily responsible for it.
Although 53 states and territories temporarily enabled providers to practice across state lines during the pandemic, the future of these policies remains murky. Some federal legislators have taken steps to push for interstate compacts that would ease the way toward clinicians practicing in multiple states. Professional organizations, meanwhile, have raised alarm about long-term relaxation of regulations.
Coverage of services is also a major potential future sticking point: Some payers have already begun to ease back on payment parity for telehealth services, potentially endangering the longevity of virtual care. The report notes that some states have limited coverage to certain modalities, such as excluding audio-only services – a practice that may make telehealth inaccessible for certain groups.
The report noted, too, that pairing payment models and incentives to move toward more value-based models may support telehealth use without unduly increasing healthcare costs.
"As more providers participate in value-based arrangements with prospective payments, including capitated population-based payments, payment parity becomes less relevant because a lower percentage of payments are based on volume," according to the report.
THE LARGER TREND
The emergence of a potential COVID-19 vaccine, along with the forthcoming transition of presidential powers, has raised new questions about the future of telehealth policy.
Although President-elect Joe Biden has supported digital health advancements in the past, he hasn't taken major steps yet to throw his support behind the expansion of virtual care.
On the agency side, the U.S. Department of Health and Human Services released final rules last week that could smooth the way toward telehealth adoption in the longer term.
"These new rulings move us closer to a value-based care model that will allow our healthcare system to reimagine how care is delivered and integrate telehealth with in-person care," said American Telemedicine Association CEO Ann Mond Johnson in a statement.
ON THE RECORD
"Telehealth has the potential to increase access to care, particularly for individuals in rural and underserved areas, as well as during a time when the nation is encouraged to physically distance," said the authors of the NGA report. "It is unlikely that policymakers will uniformly codify temporary measures after COVID-19 ends, but incremental change paired with advances in payment models, technology and evidence may lead the way to improved long-term changes."