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July 18, 2024 |  By: Deborah Van Fleet - Public News Service

Report: Keep some COVID-era telehealth 'flexibilities'; research quality, costs

telehealth

By Deborah Van Fleet - Public News Service

Receiving medical services via telehealth was a requirement for some during the pandemic but has continued to grow in popularity since then.

In states such as Nebraska with large rural areas, telehealth can be especially important. Certain pandemic-era telehealth "flexibilities" allowed by the Centers for Medicare and Medicaid will expire at the end of this year, prompting a new report by the Bipartisan Policy Center.

The report, "Positioning Healthcare Policy to Ensure High-Quality, Cost-Effective Care," recommended Congress make some of the changes permanent or at least extend them.

Maya Sandalow, senior policy analyst at the center, stressed the need for more research on telehealth. She called existing research "promising" but said it shows the quality can really vary.

"By what a person is seeking telehealth for, what service a provider is offering, and also what type of telehealth a provided," Sandalow outlined. "Is it a video where the patient and provider can see each other, or is it a visit over the telephone?"

The report supported allowing patients to continue to choose the location for their telehealth visits and allowing behavioral health services via telehealth without an in-person visit first, assuming the provider has a plan for patients in a crisis. Nebraska law has required both from Medicaid and state-regulated insurance companies since 2021, and payment parity -- paying the same rate for telehealth as for an in-person visit -- since 2023. However, only the Centers for Medicare and Medicaid Services can establish the guidelines for Medicare.

Sandalow acknowledged some believe payment parity is crucial to maintain access to services, whereas others fear it may "incentivize" providers to offer only telehealth services. But she stressed there is no doubt telehealth increases access to care, especially when it comes to behavioral and mental health services.

"It can be really high quality, equally good as compared to in-person care," Sandalow contended. "We're living in a behavioral health crisis, and any measures to expand access to care are really important."

Jed Hansen, executive director of the Nebraska Rural Health Association, said in addition to improving access, some find telehealth a more comfortable way to receive mental health services, especially in smaller communities.

"It just helps create that additional privacy by being able to stay in your own home or even close the door in your office and take that meeting," Hansen explained. "As opposed to having to drive and park your vehicle in front of a mental-health place."

Sandalow emphasized the need for the Centers for Medicare and Medicaid Services to find a way to assess the quality and costs of fully virtual providers and telehealth companies in particular.

On a related note, Hansen stressed the need to ensure telehealth regulation does not make it easier for out-of-state providers to interfere with the ability of Nebraskans to maintain a relationship with their local provider.

"What we don't want to have happen are these sweeping telehealth bills, and then to have an Amazon or a Walmart, or someone on the West Coast, that may not be providing an apples-to-apples service, and they'll come in and undercut the local health care system," Hansen cautioned.