![]() Yet, to be prepared for any future pandemic, sustained adoption of telehealth is needed. Removing long-standing regulatory constraints on payment for telehealth services resulted in high adoption rates across the nation during the COVID-19 pandemic. 9 CMS also allowed Medicare Advantage plans to add more telehealth benefits during the crisis without going through the normal application review process. 11 Commercial plans expanded their policies, which also resulted in increased utilization with some plans implementing payment parity, removing copays, and offering telehealth services for free. 9, 10 Approximately 34.5 million telehealth services were delivered to Medicaid and CHIP beneficiaries from March through June 2020, which represents an increase of 2,632% compared with March through June 2019. 8 As the pandemic took hold, many states also took action to expand broad coverage and payment of telehealth services under Medicaid and allow out-of-state providers to treat their residents using telehealth. According to Medicare claims data, Centers for Medicare & Medicaid Services (CMS) reported an increase in utilization of ∼12,000% in just a month and a half between early March and mid-April 2020. With relaxed regulations, the number of Medicare beneficiaries using telehealth skyrocketed in the early weeks of the pandemic. However, with the arrival of the COVID-19 pandemic, the crisis triggered rapid federal and state-level temporary policy changes that lifted many of the legacy coverage and payment barriers and accelerated adoption during the outbreak. 6, 7 Licensure, privacy and security, remote prescribing of controlled substances, and other related policy, legal and regulatory matters are subject to myriad rules and guidelines promulgated by various regulatory bodies (see details below). Restrictions placed on provider reimbursement have been cited as the number one barrier to adoption. Coverage and reimbursement policies vary among the different payers/plans (e.g., Medicare, Medicaid, and private insurers) and may be defined by state telehealth parity laws. Health care services delivered through telehealth and other communications technologies are regulated at both the federal and state levels. 1–4 Despite evidence showing high-quality outcomes, satisfaction, and success rates (e.g., 95% patient satisfaction rate and 84% success rate in which patients were able to completely resolve their medical concerns during a telehealth visit), 5 nationwide adoption of telehealth has been quite low due to policy and regulatory barriers, constraints, and complexities. Telehealth can also help address health income and access disparities in underserved communities by removing location and transportation barriers, unproductive time away from work, childcare expenses, and so on. Reports, studies, and surveys have demonstrated telehealth provides opportunities to make health care more efficient, better coordinated, convenient, and affordable.
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