The state of Telehealth today as cross-state waivers expire 

Jul 18, 2022

Over the past couple of years, telehealth has greatly expanded healthcare access to many communities, especially during the pandemic when in-person visits had to be avoided. Today, it continues to serve as a convenient and safe tool for both patients and providers, including those in rural areas and who may not need in-person treatment. 

However, as the Public Health Emergency could end at any time, congressional leaders are being pressured to make telehealth flexibility permanent. The reversal in telehealth access has been happening gradually as pandemic-era emergency health orders are being turned back, while some are reimposing rules about doctors practicing in multiple states.

Although there are concerns about quality, costs, and potential fraud in telehealth, lobbying efforts from healthcare providers and the public are ramping up to ensure that the benefits of telehealth don’t vanish.

What is telehealth and why is it important? 

Telehealth was already around before the pandemic, but federal regulations restricted those services. Telehealth didn’t gain popularity until 2020, prompting Congress to loosen up the rules. The Department of Health and Human Services Office of Inspector General found that Medicare patients used telehealth 88 times more during the first year of the pandemic than they had in the year prior. 

Since then, telehealth options have expanded to texts, phone calls, images, and virtual visits, but also to patient health portals for rural and remote patients. Telehealth prevents COVID-19 spreading as many people were able to quarantine in the safety of their own homes, and relieving healthcare resources for those that need it the most. 

How does telehealth support healthcare providers?  

Telehealth also helps doctors and clinicians manage workloads and compress the backlog of future demand for services. Healthcare providers also use Artificial Intelligence in conjunction with telehealth to keep track of health trends, calculate data, and better predict patient behavior and organizational needs.Telehealth technology also helps alleviate clinics that are short-staffed, and going virtual also helps alleviate some gaps in health equity.

What are the barriers of telehealth that we should be concerned about? 

Some of the major barriers of telehealth today are practitioner licensing and location, and rural accessibility.

Doctors are required to have a license from the state where a patient is located; some state laws are making it difficult for people to have virtual appointments with doctors in other states. During COVID-19, patients had many reasons as to why they wanted to see a doctor based in another state, whether the patient moved or had limited services in their area, such as mental health.

Rural Nevadans have access to these services as well, but there’s also a caveat of living in those areas; according to the Center for Disease Control and Prevention, only 60 percent of people in rural areas have access to telehealth services, compared to 95 percent of people in larger cities. On top of that, many lower income individuals, racial, and ethnic communities may miss out on the benefits of telehealth; lower income individuals are less likely to take advantage of telehealth services. Marginalized racial and ethnic communities may also miss out on the benefits of telehealth. Meanwhile, 71 percent of Black adults and 65 percent of Hispanic adults report having broadband internet access at home, compared with 80 percent of White adults.

Higher costs and potential fraud also present barriers to telehealth, according to The Government Accountability Office. The Congressional Budget Office found that terminating restrictions for coverage of mental health through telehealth would add costs to Medicare (Dec. 2020). 

Congress will need to act soon to ensure the temporary reimbursement expansions for telehealth to continue after PHE officially ends. You may need to shop for other insurance options, including a qualified health plan through Nevada Health Link, but you also will find providers that offer telehealth services in the state. 

Nevada Health Link is the state-based online health insurance marketplace where you can find qualified health plans that meet the standards of the Affordable Care Act. Other companies may target you and we encourage you to look to Nevada Health Link or your health insurance plan for the most up-to-date information.