The coronavirus pandemic has renewed interest in telehealth—the practice of letting patients consult with doctors directly, via phone or video-conferencing. This method of health care delivery offers obvious advantages, allowing patients to get personal medical advice quickly, without having to come to the doctor’s office first.
President Trump reiterated his commitment to clearing away barriers inhibiting the use of telehealth. And lawmakers have already moved to clear some away. But they can and should do more.
Earlier this month, Congress approved its first bill to combat the new coronavirus. One small provision that relaxes legal restrictions on telehealth treatments for Medicare patients could have an outsized impact.
The change would be welcome, even in the absence of coronavirus. Medicare patients living in geographically remote areas frequently have to travel long distances to get an appointment in a physician’s office. Now, some of these patients will have an opportunity to take advantage of the “virtual visit.”
Telehealth will help doctors manage the pandemic, because patients can get an initial screening, by phone or through their computer. Doctors can use that screening to determine if they should come in for an office examination. It also helps patients avoid crowded waiting rooms, where they may be needlessly exposed to other sick people.
This health care delivery method can benefit most anyone. But with a disease like this, which takes its greatest toll among the elderly, telehealth can be particularly advantageous to Medicare patients.
I am not a senior, but I use telemedicine regularly and can attest that it is much easier than going into a doctor’s office. The last time I had the flu, I used my iPhone and had four “FaceTime” discussions with a doctor over the course of 10 days. Each time, the doctor slightly adjusted my medication, helping me feel immediate relief while saving me the hassle, exposure and effort of an office visit when I was, in fact, really too sick to leave the house. And the doctor’s office staff let me know when I did need an in-person visit to take care of those things we couldn’t handle over the IPhone.
My positive experience with telehealth is the norm. A case study of patients receiving virtual care through Massachusetts General Hospital found that 90 percent felt it had “significantly improved their health care experience.”
Such positive experiences, and such access to timely patient care, have fueled a rapid growth in the use of telemedicine. According to Heritage Foundation research, telehealth consultations with physicians increased by 643 percent between 2011 and 2016. And, in recent weeks, the coronavirus has prompted hospitals to review and fast-track the implementation of additional telemedicine projects.
Despite the clear benefits of telehealth for efficient care delivery, federal and state regulations are still making it hard for this market to grow.
Under previous Medicare regulations, for example, doctors in Medicare Advantage plans couldn’t submit bills if they used phone, email, or Skype to consult with patients remotely in deciding whether or not they needed an in-office visit. However, recent changes to Medicare Advantage rules have made it easier for doctors and patients to use telehealth.
Those welcome rule changes should be just a beginning. Other barriers to the wider use of telehealth remain. Among them are wide variations in the description of telemedicine among the states, with different definitions, regulations and reimbursement arrangements. Only nine states have issued licenses related to telehealth that allow an out-of-state licensed medical professional to render services using telehealth.
Other common restrictions, according to the Center for Connected Health Policy, include the types of services and providers that can be reimbursed, whether someone has to have an in-person visit with a physician first, or whether patients can access telemedicine from their own home.
Because state lines are no barrier to virtual consultations, state officials should review their laws as well as their regulations and ensure they allow their residents to see doctors across state lines. States should lighten requirements that block virtual consultations, such as requiring an in-person visit before a provider can see a patient via telemedicine.
Meanwhile, Congress and the Trump administration should continue to work cooperatively to eliminate the remaining statutory and regulatory barriers to the broader use of telehealth, not only in Medicare, but also in Medicaid and other federal health care programs.
This piece originally appeared in The National Interest on 3/15/20