The COVID-19 pandemic revolutionized the delivery of healthcare. Prior to the public health crisis, telehealth was a niche privilege reserved for only fringe cases. However, the onset of COVID-19 prompted the Centers for Medicare & Medicaid Services (CMS) to expand its coverage of telehealth options. Now, according to a recent poll, more than 61% of Americans have experienced a virtual appointment—up 300% from just a year before.
But what is the future of telehealth as we move forward from the pandemic and return to in-person visitations? Almost 88% of the survey respondents want to continue using telehealth for non-urgent appointments, indicating a huge demand to keep many remote services permanently. A virtual world has both its pros and cons, and there are many factors that we need to consider as we plan for the future.
More accessible healthcare
One of the key benefits of remote care is the geographic gap it closed between physicians and their patients. Transportation and location once posed serious barriers when it came to scheduling medical appointments, especially in rural or low-income communities. Now, telehealth allows doctors to reach patients who have slipped through the cracks of the traditional health care system.
On top of reaching underserved communities, telehealth can bring specialized services into communities that lack in-person providers. In a recent testimony from the American Hospital Association, one hospital reported a 10-fold increase in access to specialists while reaching 39% more ZIP codes in their state through the use of telehealth.
After witnessing the effect that remote healthcare delivery can have on a community, many healthcare professionals, patients, and even politicians have expressed interest in keeping telehealth long-term. In February of 2021, senators Tim Scott, Brian Schatz, and Jeanne Shaheen introduced the Telehealth Modernization Act in an attempt to protect access to healthcare in rural areas and lift limiting telehealth restrictions.
Optimized long-term care
Telehealth has overall been found to be able to support the delivery of high-quality and guideline-satisfying medical care, making it especially useful in the treatment of individuals with chronic conditions, like cardiovascular disease or mental illness.
For instance, behavioral health saw a significant increase in the use of telehealth as it didn’t require any in-person treatment and was often-times more comfortable for patient to be at home. Various studies have found sufficient evidence to advocate for the use of telehealth in delivering effective psychological treatments.
Looking to the future, many providers believe telehealth could play a vital role in managing chronic conditions and reducing spending on hospital visits. Kishlay Anand, MD, founder and CEO of Akos, a telehealth company, says, “You will still be able to see your provider and still go to the hospital, but for that high-risk chronic care group, using telehealth and virtual care management is going to be mainstream going forward, and that’s critical to bending the cost curve in health care.”
As mentioned earlier, the Centers for Medicare & Medicaid Services (CMS) expanded its coverage of telehealth options during the COVID-19 pandemic. Prior to the pandemic, telehealth was generally limited to patients in living in rural areas and saw approximately 15,000 Medicare users each week. Following the onset of COVID-19, at least 24.5 million of 63 million Medicare beneficiaries utilized telehealth between March and October of 2020.
Now, it appears that telehealth is here for the long run. In December 2020, CMS announced that it would be permanently expanding more than 60 telehealth services following the pandemic. “Medicare beneficiaries will now be able to receive dozens of new services via telehealth,” says HHS Secretary Alex Azar. “And we’ll keep exploring ways to deliver Americans access to healthcare in the setting that they and their doctor decide makes sense for them.”
Private insurance companies have yet to make public their full plans for post-pandemic compensation. During the pandemic, many private insurers followed Medicare in expanding coverage and waiving patient cost sharing. However, with the pandemic starting to taper off, many insurance companies are preparing to reinstate cost sharing and coinsurance payments. The issue is further complicated as some states move forward to solidify their own compensation laws introduced during the pandemic.
Although many individuals and groups have come forward and testified on the advantages of keeping telehealth services permanently, there are those who have expressed valid concerns as well. Prior to the pandemic, one of the primary concerns holding back telehealth expansion was that excessive convenience would lead to overutilization, and by extension, overspending. In 2014, Ateev Mehrotra, MD, MPH, warned in his testimony before the United States House of Representatives’ Energy and Commerce Committee that the potential to reduce the cost of in-person visitations may be outweighed by the cost of overused services.
Additionally, some physicians have expressed concern about the inability to properly evaluate certain symptoms over the phone or computer. Many illnesses require a physical exam to make a proper diagnosis, especially when the symptoms expressed are more subtle or require the use of specific equipment. Virtual appointments also make it harder to address personal topics like drug use, sexual activity, counseling upset patients, or delivering devastating news.
Any long-term plans for telehealth will also require addressing the role that telehealth has in inadvertently increasing the digital divide and disparities between different populations. Low-income, non-English speaking, and those with limited digital literacy are at particular risk of being left behind. For instance, a recent study found that during the pandemic, the uptake of telehealth in low-income communities was one-third of that in wealthier neighborhoods.
A future where providers will be weaving telehealth in with in-person visitations and remote patient monitoring also poses a logistical nightmare. Generating massive amounts of data from multiple sources makes it difficult to accurately track patient information between different clinics and physicians. Any form of long-term solution to telehealth will require the implementation of analytics tools to manage and keep up to date with vital patient data.
As we move forward from the pandemic, there are still many questions that need to be addressed before we’re able to proceed with any long-term plans for telehealth. Although the apparent benefits of virtual care have garnered support from people across the country, the adverse consequences of a remote healthcare delivery system need to be taken into consideration. To read more about what the healthcare industry learned from the pandemic, check out our white paper on the Forrester Q&A. Lessons Learned by Healthcare Organizations During the COVID-19 Pandemic.
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