What is the Future of Telehealth?

November 15, 2023

The pandemic accelerated America’s transition to telehealth, with easing regulatory hurdles supporting a 63-fold increase in digital care.

Now, lawmakers are weighing what comes next.

This week, the Senate Finance Health subcommittee hosted a hearing about the future of telehealth and steps to make it a permanent part of the Medicare program. The hearing comes as Congress must consider which pandemic-era telehealth rules to keep through next year.

“Currently, telehealth accounts for 10 percent of office visits, a rate that has been stable since July 2021 and is anticipated to remain so until December 31, 2024,” Chad Ellimoottil, MD, MS, associate medical director of virtual care at the University of Michigan, said in prepared remarks. “However, I am concerned about a potential decline in telehealth usage after that date, which could occur either rapidly or gradually. Preventing both the fast and slow death of telehealth depends on the actions of Congress and CMS.”

The hearing focused on several key issues:

• Visual, audio, and location:  The pandemic enabled access to audio-only visits, supporting patients who would struggle to receive care due to an insufficient Internet connection or lack of access to video.
  • The easing of originating site requirements—where a patient receives care—also supported access to care, ensuring patients can receive care wherever they are.
• By type:  The pandemic expanded the providers who could offer telehealth (speech-language pathologists and audiologists, and occupational and physical therapists). It also allowed federally qualified health centers and rural health clinics to offer these services.
• Payment clarity:  Panelists said commercial coverage will likely mirror Medicare’s coverage decisions, and that permanent coverage for telehealth at the federal level would offer clarity to payors.
  • Lawmakers also are reviewing how reimbursement for virtual care should compare to in-person visits.
• Care across state lines:  A return to pre-pandemic policies would again place geographic restrictions on providers caring for patients in other states. There is potential for licensure exceptions that would help providers stay in touch with their established patients when those patients travel or move, panelists said.
• Behavioral health care:  The Drug Enforcement Association (DEA) is considering future rules to ensure access to certain medications for opioid use disorder via telehealth while preventing diversion of these controlled substances.
  • The regulations also will outline when in-person care is needed for mental health services.

In a letter this week, the American Hospital Association (AHA) urged the committee to maintain pandemic-era telehealth waivers that improved access to care.

“Hospitals, health systems, providers, and patients have seen the benefits and potential for telehealth to increase access and transform care delivery,” the letter said. “We appreciate your leadership on this important issue and look forward to working together to ensure telehealth permanency.”

HAP supports state and federal legislation that supports telehealth across the commonwealth. This includes making permanent pandemic-era policies that have made it easier for patients to access the care they need to live healthy lives.

Earlier this year, HAP submitted a comment letter to the DEA to preserve patient access to buprenorphine and other critical medications classified as controlled substances via telehealth. Learn more about our telehealth advocacy.

The Senate Finance Health subcommittee hearing is available online.

For more information, contact John Myers, vice president, federal advocacy, or Kate Slatt, vice president, innovative payment and care delivery.