Reviewing a treasure trove of data as a result of the COVID-19 pandemic, researchers determined over time, consumers tend to use fewer health care services if they are given easy access to telehealth.
The study, “Telehealth Saves Money and Lives – Lessons from the COVID-19 Pandemic,” by two activist organizations that straddle the ideological divide, found that between January 2020 and February 2021, telehealth consumers spent $674 or 61 percent less on their overall health expenses.
Telehealth appeals to both sides of the political spectrum for a few reasons say the co-authors. “This is an issue that transcends underserved urban communities and rural areas where doctors may be in scarce supply,” said Arielle Kane, the director of health care at the Progressive Policy Institute.
“There are so many benefits that come with telehealth and so many harmful regulations imposed on telehealth. The most important thing is helping consumers and patients. The fact that we disagree on a whole lot of other things simply doesn’t matter because there is this real opportunity to advance something that benefits everybody, said Charlie Katebi, a health policy analyst with Americans for Prosperity.
Putting Telehealth to the Test
Americans for Prosperity and the Progressive Policy Institute, the two groups behind the study, saw the COVID-19 pandemic health response as an opportunity to measure how telehealth impacts health care utilization. During the pandemic when then-President Donald Trump declared a public health emergency, the U.S. Department of Health of Human Services (HHS) lifted regulatory obstacles that prohibited people from using telehealth.
Before the pandemic, Medicare, which often sets the standard for all insurance coverage, would only cover telehealth in rural areas and at that, only in a health care setting, not at home. The regulations were based on the presumption that enrollees would overutilize health services if they were too accessible. Clinicians, too, had been hesitant to jump on the telehealth bandwagon because of the belief it could disrupt payment models.
Because much of the economy, including health services, was shut down to stop infection, the Trump administration temporarily allowed reimbursement for 240 new telehealth services and offered payment parity for telehealth visits to get clinicians on board. Additionally, states waived rules to allow other health care providers besides doctors and nurses to offer telehealth and to expand telehealth platforms to include emails, texts, and online video streaming.
Consumers Jump
Consumers immediately jumped onto the telehealth bandwagon. According to the report, telehealth usage increased over 7,400 percent in the first six months of 2020, from 134,000 users to 10.1 million.
The authors then reviewed the claims data of patients who used telehealth and compared it to patients who used in-person care alone. When the virus threat subsided, telehealth patient costs fell faster than in-person patients. In January 2020, in-person patients spent $910 while telemedicine patients spend $1,099. In February 2021, in-person patients spent $578, or 36 percent while telemedicine patients spent $425, or 59 percent less.
One explanation is telehealth reduced exposure to the virus and easy access helped improve health outcomes, Katebi tells Health Care News. “It delivered a lot of lifesaving care that would not have happened if the Trump administration did not end those restrictions.”
Kane says there are pros and cons to telehealth. “Not every type of care will be appropriate for virtual care,” said Kane. “However, many services can be comparable: think the opportunity to renew prescriptions, ask questions, and do talk therapy. All of this can be done remotely without sacrificing quality.”
“There are so many health care services that can be delivered through telehealth and at a fraction of the cost,” said Katebi. “The average primary care visit averages between $100 to $150. A telehealth visit costs about $40 a visit.
Additionally, telehealth can offer services a face-to-face visit can’t always offer, says Katebi. “Consultation is easier and people with chronic conditions can wear medical devices that allow doctors to monitor 24-7. That is a level of care that you didn’t have before telehealth services.”
A Reform Everyone Can Love
Katebi and Kane say telehealth is a health care delivery reform where Republicans and Democrats often find common ground.
Congress needs to act now because when the administration lifts the emergency health declaration, the telehealth reforms will vanish.
Three bills in the U.S. Senate, the Protecting Rural Telehealth Access Act, introduced by Sen. Joe Manchin (D – West Virginia), the Telehealth Modernization Act, introduced by Sen. Tim Scott (R – South Carolina), and the CONNECT for Health Care Act, introduced by Sen. Brian Schatz (D-Hawaii) and a bipartisan group of 59 co-sponsors, will allow telehealth anywhere in the country and multi-platform access to service from a patient’s home.
“I don’t think I’ve seen any other bill with that level of support in the Senate for anything,” said Katebi.
States are already taking action in expanding access to telehealth. “Florida allows an out-of-state provider to practice in their state. They just ask that they register and demonstrate that they have all of the qualifications to practice medicine,” said Katebi. “Arizona just passed a carbon copy of that reform and we’re working with Kansas and West Virginia to implement similar reforms.”
“This, along with action at the Congressional level would really open up access,” said Katebi.
AnneMarie Schieber (amschieber@heartland.org) is the managing editor of Health Care News.
Internet info:
Charlie Katebi, Arielle Kane, Maha Subramanian, “Telehealth Saves Money and Lives: Lessons From the COVID-19 Pandemic,” Americans for Prosperity, Progressive Policy Institute, December 2021.
