The House Energy and Commerce Committee held a hearing this month to discuss extending pandemic-era policies that expanded access to telehealth under Medicare. Without urgent action by lawmakers, these telehealth flexibilities will expire at the end of the year.
That's an outcome few should welcome. Telehealth has proved enormously valuable to older Americans, particularly those living in rural areas. Medicare beneficiaries should have unfettered access to remote care permanently.
Before the pandemic, a host of rules made it difficult for seniors to seek — and physicians to deliver — treatment remotely, whether through a video consultation or an audio phone call.
When COVID-19 confined everyone to their homes, "Congress and the Centers for Medicare and Medicaid Services acted to remove barriers that had previously prevented many seniors from utilizing telehealth," as the Energy and Commerce Health Subcommittee Chair Brett Guthrie, R-Ky., put it at a hearing this month.
The number of services Medicare covered via telehealth more than doubled, to 260. Seniors no longer had to have a pre-existing relationship with a provider to receive remote mental health care.
Patients have embraced this four-year experiment with remote care. Telehealth utilization jumped tenfold among Medicare beneficiaries between April and December of 2020, compared to the same period a year earlier.
Between April 2021 and August 2022, well over one-quarter of Medicare seniors reported having used some form of telemedicine in the previous month, according to an analysis by the Department of Health and Human Services.
Telehealth has been particularly effective at expanding access to behavioral health care. In the first three months of the pandemic, 60% of Medicare beneficiaries who received psychiatric care did so remotely.
Across all types of patients, nearly 4 in 10 telehealth visits between March and August of 2021 were for mental health or substance use diagnoses, according to research from KFF.
A study of University of California health care facilities found that, during the two years of the pandemic, telehealth technologies saved patients a total of 53.7 million miles in travel.
That's a boon for rural patients, who otherwise might struggle to make their way to metropolitan areas where providers, especially specialists, are disproportionately located.
Data on mental and behavioral health visits bear that observation out. Fifty-five percent of outpatient visits for mental health and substance use disorder among rural patients between March and August 2021 took place remotely, according to KFF.
Telehealth can save patients and the health care system money, too, by preventing unnecessary trips to the emergency room and helping deliver diagnoses sooner.
And by linking providers in remote areas with colleagues, particularly specialists, in other cities, telehealth can even reduce isolation and burnout among rural physicians. In this way, telehealth can actually help recruit and retain physicians in underserved communities.
Some skeptics of expanded access to telehealth worry that it could increase the risk of fraud. Would crooked providers bill for remote care that they don't deliver — or that they deliver poorly or at a lower standard than they might in office?
Those concerns appear to be overblown. In his remarks at last week's hearing, Rep. Guthrie cited an Office of Inspector General report that found that fewer than 2,000 of the more than 700,000 providers who delivered telehealth during the pandemic needed further scrutiny for their billing practices. That's less than 0.3%.
Patients want to have the option to receive care remotely — especially when the alternative might be to wait or forgo care altogether. The pandemic proved that telehealth is not just a viable alternative to an in-person visit with a provider but an effective way to expand access to care.
There's no shortage of proposals from lawmakers of both parties for expanding access to telehealth for Medicare beneficiaries permanently. Congress must now make good on that widespread legislative interest.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
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