Are you among the many persons who turned to telehealth during the last year? Faced with the pandemic, health care professionals innovated and patients adapted to new technologies and procedures to safely administer and access health care. However, it is possible that flexibilities granted to support telehealth during the public health emergency could end unless lawmakers act. The federal government has indicated it will continue the public health emergency until the end of 2021, but many states are ending their emergency declarations as the country recovers and reopens. This post provides an overview of proposed policies, areas of focus for policymakers, and the future permanency of telehealth at the state and federal level. Lawmakers are considering the appropriate scope of telehealth services, reimbursement policies, and patient access, to name just a few.
At the federal level, congressional committees are looking closely at the future of telehealth, particularly in the context of Medicare following the dramatic increase in use of telehealth services over the last year. Multiple hearings focused on telehealth have been held, including by the U.S. House Energy & Commerce Committee, House Ways & Means Committee, and U.S. Senate Finance Committee. Members of Congress have also introduced multiple pieces of legislation in support of telehealth, including the CONNECT for Health Act, bipartisan legislation introduced in the U.S. Senate to permanently expand access to telehealth services, including eliminating geographic and originating site restrictions (to continue to allow patients to receive telehealth services from their own home) and more. Similar legislation that would make permanent certain telehealth flexibilities has been introduced in the U.S. House of Representatives.
Additionally, federal legislation has been introduced to support providing telehealth services across state lines (the TREAT Act) as people moved around during the pandemic. At the state level, work on the Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC) began years ago and just recently crossed the necessary threshold for the commission to begin drafting the rules and bylaws to create an interstate licensing system for states that have adopted the compact. This would allow for audiologists and speech-language pathologists to provide care in multiple states, either in person or virtually, which could enable them to continue caring for patients who may have moved to another state.
There is enthusiasm around and bipartisan support for the future of telehealth, but there are also policymakers that support taking a step back and fully assessing the use and impact of telehealth during the pandemic. This may include considering the potential for increased costs and concerns around preventing waste and fraud, particularly with federal programs such as Medicare, as well as ensuring the services provided via telehealth are on par with those provided in-person.
Critically, COVID-19 telehealth flexibilities also raised visibility of existing disparities in health care. During the pandemic, telehealth coverage was expanded in many programs to not only video telehealth visits, but to audio-only appointments as well to provide access to the millions of Americans who live in rural or economically challenged areas and may not have the ability to meet with a medical professional via computer or video call. Going forward, the future of telehealth includes discussions of investments in broadband infrastructure needed to ensure equitable access to telehealth services for all.
Telehealth can provide a platform for innovation, increased access to services, and an opportunity to address disparities in health care. Telehealth is a rare area of bipartisan enthusiasm, and we could be on the threshold of a transformative time in health policy and the delivery of health care.