The future of telehealth hinges on quality of care and payer reimbursement policies

The growth of telemedicine over the next few years will hinge on how payers evolve their reimbursement policies, and the quality of care patients receive.

mobile telehealth

The COVID-19 pandemic has created much more awareness around the need and potential of telehealth, with people around the world coming to appreciate the value, convenience, and accessibility of virtual care.

While the general consensus amongst healthcare analysts is that telehealth will continue to be popular amongst patients and providers in 2021, the growth of telemedicine over the next few years will hinge on how payers evolve their reimbursement policies, and the quality of care patients receive.

Payer reimbursement policies

Following CMS changes for telehealth in March, many health insurance companies across the U.S. have been reimbursing clinicians for video consultations at the same rate as in-person visits, making it much more feasible and attractive for clinicians to offer telemedicine. State legislation has mandated many of these reimbursement policies, as detailed in JD Suptra’s, Tracking Telehealth Changes State-by-State in Response to COVID-19.

As the pandemic subsides in 2021 and beyond, health insurance companies could revert back to their pre-2020 telehealth reimbursement policies, forcing clinicians to make difficult business decisions around the level of access that they can offer. This would be an unfavorable outcome for patients and providers, but there’s reason to be cautiously optimistic that payers will see that continuing to support the expansion of telehealth is arguably in their best business interests.

With the adoption of telemedicine at an all-time high, payers, providers and legislators have a wealth of data to prove the worth of telehealth, specifically when it comes to bringing down long-term healthcare costs.

Even if telehealth is reimbursed at the same rate as in person visits, the expansion of telehealth availability could encourage more people to access preventative care and avoid delaying care until the situation turns more acute. This increased engagement will allow clinicians to identify more timely interventions and telemedicine tools can provide additional insight for clinicians about how to support positive behaviors such as treatment adherence. Better patient outcomes can translate into decreased long-term healthcare costs, which is good for patients and payers alike.

These cost-savings will also be particularly important to states overseeing their Medicaid budgets. The COVID-19 pandemic has caused more people to be eligible for Medicaid, which has resulted in a higher deficit at the state level to finance Medicaid programs. In 2021, states will have to begin looking at ways to decrease costs related to Medicaid, and increasing the use of telehealth could be one of the avenues they explore.

Quality of care: thinking beyond video consultations for telehealth

In 2020, the sudden dangers of in-person gatherings drove the meteoric rise of telehealth. And while reports such as this Kyruus survey have indicated that people have been happy with their telehealth services overall, patients could hold the quality of telehealth services to a higher standard when an in-person visit is no longer associated with the risk of COVID-19 transmission.

As telehealth providers look towards improving quality of care, one area to focus on is leveraging the full arsenal of telehealth tools, which expand beyond synchronous video consultations to phone calls, live messaging and asynchronous texts. Combined, these communications methods can provide care that fits into the patient’s lifestyles and improve patient engagement.

For example, a person living in a rural area with an unsteady internet connection might have a more reliable experience messaging with a clinician. Alternatively, live messaging might be best for a working mother-to-be who has a concern come up in the office and does not have the privacy for a video consultation. The importance of a patient-centric approach to delivering care goes beyond convenience — it creates more access.

Continuing to expand telehealth services is an important step for improving healthcare equity. Over the next few years, our hope is that payers will sustain their support of telehealth through reimbursement policies to ensure patients can continue to access convenient, high-quality and affordable care.

Amy Fan and Bruno Van Tuykom are co-founders of Twentyeight Health, a telemedicine company for women’s sexual and reproductive care. Prior to co-founding Twentyeight Health, Van Tuykom worked for the Gates Foundation, where he focused on increasing access to healthcare for Family Planning, HIV and Malaria. Fan has a Master of Public Health from University of California, Berkeley, and was a research and special projects fellow at Rock Health.