Telehealth was a literal lifeline for patients during the COVID-19 public health emergency, ensuring access to a physician’s care without the risks of leaving home. This was only possible because Congress acted quickly to implement legislative and regulatory flexibilities that broadened the reach of remote patient care to benefit patients in rural and underserved areas.
It is past time we make these flexibilities permanent and secure telehealth’s future as an essential element of our patient toolbox.
We must remember that before the pandemic, Medicare paid for only a limited number of telehealth services, and did so only for patients who resided in rural areas and traveled to a medical facility to receive them. The AMA led the fight to lift those and other restrictions so that patients nationwide could not only access telehealth services, but receive them in their own homes. Our continued advocacy helped secure passage of federal legislation that extended pandemic-related telehealth flexibilities through the end of this year.
Although telehealth use has since declined, AMA research shows that 74% of physicians still work (PDF) in practices that offer telehealth—nearly three times the share in 2018. That higher rate of use is partly because of the temporary removal of those restrictions. The AMA firmly believes these COVID-19 public health emergency-era changes should be made permanent so that patients and our health care system can continue to reap the immense benefits they continue to provide. We outline the many reasons why in an April 10 statement (PDF) filed with the House Energy and Commerce Subcommittee on Health. On May 8, the House Ways and Means Committee unanimously passed a bill that would extend these expiring telehealth flexibilities for two more years.
What’s needed is a long-term fix, and there is bipartisan legislation in Congress right now that could deliver it. The CONNECT for Health Act (S. 2016/H.R. 4189) would permanently repeal existing Medicare geographic site restrictions and allow patients to receive telehealth services wherever they can access a telecommunications system—including their own homes. As odd as it may seem now, that flexibility did not exist before the pandemic. That same flexibility also allowed patients in urban and suburban areas to receive telehealth services for the first time.
In turn, expanded telehealth services have paved the way for new and innovative hybrid models of care delivery that combine in-person care, telehealth services and remote monitoring that meet patients’ needs more effectively. We must not relinquish the opportunity our pandemic response affords us to ensure that all Americans—including rural, underserved, and historically marginalized populations—can receive full access to the care they need.
Telehealth’s benefits are well-established
The benefits of expanded telehealth implementation are as numerous as they are clear. Telehealth allows physicians to boost continuity of care by extending access outside of normal clinic hours, while reducing the impact of physician shortages among underserved populations and those in rural areas.
This technology can help physicians better manage cardiovascular disease, diabetes and other chronic illnesses among their patients, while dissuading patients from delaying care for conditions that might otherwise result in emergency department visits, hospital stays or worse if left undetected. Telehealth boosts communication between patients and physicians and strengthens the trust found at the center of that relationship.
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While telehealth alone will not solve all our health care problems, its use is critical to the future of medicine. Patients are better served when telehealth practices are blended into physician practices and the larger health care delivery system. The AMA is constantly working to ensure physicians have the tools, research and resources they need to seamlessly integrate this technology into their practices. Last year, the AMA House of Delegates addressed the need for greater equity in telehealth by adopting policy to expand digital literacy and strengthening efforts to reach members of historically marginalized and minoritized communities.
The AMA STEPS Forward® Innovation Academy and our Telehealth Implementation Playbook are just two of the many resources we offer to help physicians broaden and optimize telehealth services through peer-to-peer training and other methods.
Telehealth payment parity
The AMA firmly supports coverage parity that requires payers to cover a service via telehealth if it is also covered in-person and can be delivered remotely while meeting the standard of care. We also support fair and equitable payment requirements that are applied in a uniform way across the full range of clinical services, regardless of whether the service is rendered through audio-only means, an audio-video connection, or in person.
Telehealth has become an essential element of health care delivery today, and coverage and payment of services via telehealth must be part of that equation. The time has come to ensure that payers fully recognize the vital role this technology plays by ensuring coverage parity as well as fair and equitable payment for telehealth services. The AMA is committed to a health system in which patients have routine access to remote care, and physicians are properly compensated for our time and expertise in delivering that care.
The AMA is working with Congress to secure comprehensive and permanent solutions to ensure Medicare beneficiaries continue to receive uninterrupted access to affordable, high-quality health care, including virtual care. We can realize this goal by building on the telehealth and at-home care gains we achieved during the pandemic, so that all patients have access to the care they need no matter where they live.
