|
Six years after the COVID pandemic, the virtues of remote health care are clear: Allowing patients to visit with their providers via phone or video call often means better access to health care for patients, including those in rural communities and those who struggle to leave their homes.
But the laws that regulate telehealth have not kept pace with its rise and demand. Since the pandemic, Congress has funded telehealth largely on a stopgap basis, temporarily extending COVID-era flexibilities more than a dozen times in the last few years. Each time, the extension provides only temporary funding to the Centers for Medicare and Medicaid Services — the nation’s largest funder of telehealth services.
The newest deadline for Congress to act on telehealth policy — the 15th deadline set on this issue since the COVID pandemic — is Jan. 30.
In a recent article in the New England Journal of Medicine, Tara Sklar, faculty director of the Health Law & Policy Program, together with co-author Barak Richman of the George Washington University, argues that the temporary funding measures for telehealth are not helping patients.
Professor Sklar discussed her article, federal telehealth policy and the human impact in a Q&A with the University of Arizona. Excerpts are below. The full article is available here.
Q: What’s at stake if this deadline comes and goes with no action from Congress?
A: What makes telehealth accessible is that you can do it from your home — or, really, a patient could do it from anywhere. So, first and foremost, if the waivers don’t come back into place, it would restrict telehealth to certain geographic areas, where it has to be a rural area or an area with a health professional shortage. Medicare beneficiaries who don’t live in those geographic areas will not be covered by Medicare for telehealth services.
Q: Why is it such a thorny issue for Congress?
A: The Congressional Budget Office has a really high price tag associated with these telehealth visits. They say it’s going to cost the Centers for Medicare and Medicaid Services as much as $4 billion over the next two years if we renew these waivers because people will get care perhaps more frequently. Many have also made the argument that patients are getting care in a more timely manner, so it’s saving costs later on, meaning that it’s still high-value care.
But I think the reality is — and why I co-authored the piece — that we have to separate out these telehealth flexibilities from the overall budget appropriations bills. Otherwise, it seems likely that there will continue to be potential government shutdowns and these impasses disrupt care, and the Medicare telehealth flexibilities are a victim of that.
Q: What’s the human cost of not having comprehensive telehealth policy?
A: The stories that break my heart are the ones where a Medicare beneficiary has dementia and getting out of the house for a 15-minute visit is just harrowing. I worked with a geriatrician at the University of Virginia on a blog post, and in it, she describes what it’s like to go to see the doctor if you’re older and live either in a rural area or have any kind of severe cognitive impairment. It’s not just the Medicare beneficiary — it’s their loved ones, it’s their time away from work, from caring for children, it’s time away that is not easy to find.
| 
.gif){kind=small}
