Experts Push to Preserve Telehealth, Payment Parity Post Pandemic

In various interviews with The American Journal of Managed Care®, experts highlight key health care infrastructure and policy changes that emerged from the COVID-19 pandemic and should be maintained long-term.

All experts support the continued use of telehealth for the flexibility it provides to doctors and patients. Similarly, they emphasize the importance of maintaining insurance coverage for telehealth visits and upholding the telehealth payment parity policy, which ensures physicians receive comparable reimbursement for virtual and in-person visits.

Featured experts include Jason Bellet, cofounder and chief business officer of Eko Health; Geoffrey Rutledge, MD, PhD, cofounder and chief medical officer of HealthTap; and Dan Nardi, MS, CEO of Reimagine Care.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

What positive changes in health care infrastructure or policy have resulted from the COVID-19 pandemic? Which should be maintained long-term?

Bellet: In my opinion, one of the most important policy changes during COVID-19 was telehealth payment parity. While telehealth should certainly be used when it's appropriately indicated for the patient, it's still really important that providers see their patients in person. What it allowed providers to do was to see patients virtually and increase access for hard-to-reach or underserved patient populations and to be paid the same for doing so.

For a patient in a rural community who may otherwise not have been able to see a cardiologist, today, they can go into a local clinic or even a pharmacy, sit down, and do a virtual visit with their cardiologist. That cardiologist can get paid for their work at the same rate, or a similar rate, as if they were to see that patient in person. That dramatically reduces commute times for the patients, wait times, and, overall, just the cost to deliver care.

I think we need to keep some of those reimbursement policies in place, both with respect to RPM [remote patient monitoring] and synchronous clinic-to-clinic telemedicine, in order to keep some of the benefits we got during COVID.

Rutledge: By far and away, the most important thing that came out of the pandemic was this recognition of the value and effectiveness of virtual care. What we're seeing from a policy perspective is that the adjustments that were made, for example, CMS would, prior to the pandemic, not pay for virtual care between a Medicare recipient and their doctor, full stop. They put in temporary, at the time, changes.

Technically, they're still temporary changes at this point, but the policy needed to make permanent is the valuable addition of virtual care to all members of health care, whether they're on Medicare, commercial insurance, or any other method of getting health care paid. Having virtual care, which is more effective, less expensive, and more convenient, both for doctors and patients, having virtual care covered is a pretty critical policy change.

Nardi: There's a handful of them. I think one of them is continuing to support and embrace the telehealth reimbursements. I think that's going to be a very, very important one as we move forward. How can we continue to use technology to support the delivery of care for patients, whether they're in rural settings or have different socioeconomic backgrounds? Maybe it's hard for them to get into the clinic, even if they live nearby. There could be financial and time toxicity components, which we talked about.

I think really ensuring the future and investing in the future where telehealth is embraced and continued to be used is going to be extremely important. I think the flexibility in care delivery, as well. I think it's the right combination. Telehealth is great for a lot of things, but I think there's still a very important component of the in-person care, in-clinic care. I think embracing the flexibility of all of that care like we talked about, this on-demand cancer care platform that we built, Reimagine Care.

I think, in general, even outside of cancer care delivery, it's like, how are we ensuring the right flexibility so patients can get the right care at the right time to the right modality? For some moments, it's going to be virtual and on the fly, and getting answers over the phone or text. In some cases, it's going to be a bit more severe, and they're going to need to be more in-person. I think understanding and helping to support that so that we don't end up with all these silos of care delivery, but they're actually all interoperable with the right amount of information that is supporting all of the decisions made at each of those modalities, so I think that's extremely important.

I think another one is this shift towards value-based care. In general, we, as a health care delivery society, have talked about this shift towards value-based care for a very long time, so it's a very slow march towards it, if you will. I think the pandemic really reinforced, for all the reasons we've talked about here today, the right thought about, "Okay, now's the time. We now need to make the move into this."

It is more outcomes-based, and I think that's extremely important. We can't just keep having a fee-for-service world where I just do more of it and, therefore, I get more revenue. We have to be thinking about the right outcomes for the patients and combining all of this: telehealth reimbursement, the flexibility of the right modality at the right time for the right patient. If you can do all of that, then I think it does pave a path towards getting to value-based care eventually.