Preserving Life-Saving Telehealth Reforms Critical for Latinos
Congress is not having much luck pushing large legislative priorities through small windows of opportunity. So maybe lawmakers should take aim at a much lighter lift with a much more immediate payoff — legislation that would preserve one of COVID-19’s most valuable adjustments during the pandemic: telehealth reforms.
Among the “top 10” health policy priorities of 2022, expanded access to telehealth changed healthcare — for the better — during the pandemic. The CARES Act empowered the U.S. Department of Health and Human Services (HHS) to issue public health emergency measures in early 2020 to deal with COVID-19, including orders to relax or suspend restrictions on the use of telemedicine.
Medicare, insurers, and states shifted their telehealth policies accordingly, arming providers with the ability to deliver care through widely available technology such as audio-only phone calls, online video platforms, emails, and instant messages.
Medicare, though authorized for telehealth in 2001, listed only nine available types of remote services when the pandemic hit. Public health emergency waivers allowed the agency to add more than 240 new telehealth services. For the first time, patients could remotely access emergency care, mental health consultations, and substance abuse care.
Medicare also suspended its rural residency requirement for telehealth and authorized all types of health professionals, including physical therapists, occupational therapists, and speech language pathologists to deliver virtual care.
The result provided exponentially more Americans access to a far wider variety of health services than before the pandemic, in the most socially distanced way possible.
From June 2019 to June 2020, the number of Medicare enrollees who engaged in telehealth jumped from just 134,000 to more than 10 million — a 7,400 percent increase. And telehealth patients made 64 percent fewer emergency room visits, thus confirming prior research that found early intervention through telehealth results in the use of fewer intensive services.
Another encouraging takeaway has been telehealth’s critical impact on mental healthcare. Latinos especially embraced remote services during the pandemic at the highest rate of all races and ethnicities.
Also, while Latinos were more likely to seek an emergency room for mental health services pre-pandemic, ours was the largest reduction in such visits during the pandemic’s peak in 2020.
Finally, the practice of pandemic-era telemedicine should put to rest longstanding concerns among lawmakers and bureaucrats alike that widespread telehealth means spending on unnecessary medical services.
Such concerns were the impetus for Medicare’s telehealth ban inside homes and outside of rural areas.
But an analysis of telehealth during the pandemic found that, over time, patients used fewer services and spent less money, while health outcomes improved. And monthly health expenses fell 61 percent during the pandemic from $1,099 per month to $425.
Removing telehealth barriers at the start of the pandemic expanded health access and slowed the spread of the virus. These flexibilities helped us navigate the pandemic’s most treacherous months and kept millions of Americans safe and secure.
Without telehealth expansion, outcomes during the pandemic would have been much worse.
But this crown jewel of pandemic reform is living on borrowed time, measured by HHS in each 90-day extension of the nation’s public health emergency. When the emergency is over, telehealth’s regulatory barriers will return, cutting off access to virtual care for tens of millions of patients.
Some good news came from an announcement from Medicare in November that it will extend a number of its temporary COVID-19 telemedicine reforms through the end of 2023. The agency will use the additional time to consider making them permanent additions to its service list.
Medicare’s actions are a good start, but patients need certainty that telehealth will be available long after the pandemic ends.
Telehealth proposals to extend or enshrine these healthcare flexibilities are already in the legislative pipeline. The CONNECT For Health Act, Protecting Rural Telehealth Access Act, and the Telehealth Modernization Act have been sitting in committee for months. All have strong bipartisan support and, taken together, would permanently remove geographic restrictions, allow audio-only visits in rural areas, and expand the list of approved providers.
While telehealth will never fully replace in-person care, it has proven to meet patients where they are, with greater access to much-needed medical services and without raising costs to taxpayers.
Congress should act swiftly and decisively to ensure that telehealth’s pandemic-driven life-saving flexibilities permanently outlive the public health emergency that created them. The Latino community, like all Americans, benefit from policies that strengthen access to care.
Daniel Garza is president of The LIBRE Initiative.
