According to data from the Centers for Medicare & Medicaid Services (CMS), more than 34.5 million telehealth services were delivered to Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries from March to June 2020 — a 2,600% increase from the same period in 2019. Yet, during this pandemic, healthcare utilization generally lags — as does consumer awareness of their telehealth benefits. An April survey from J.D. Power found that although 75% percent of consumers were aware of telehealth, 54% did not understand whether their insurance actually covered telehealth services.
Telehealth has not been a one-for-one trade off with pre-COVID-19 in-person healthcare visits. CMS data reveals steep drops in vaccinations, screenings and dental services among children in Medicaid and CHIP. Similar declines have been seen in adult populations as well, with 21% of Medicare beneficiaries reporting forgoing non-COVID-19-related care, even as Medicare expanded coverage for telehealth services. The most common reason for skipping care — cited by 45% of CMS survey respondents — was “not wanting to risk being at a medical facility.”
Given the continuing rise in COVID-19 cases, it is likely that this phenomenon is far from over. CMS has warned that missing care can have long-term impacts on health outcomes, issuing an “urgent call to action” for stakeholders to make healthcare services more readily available to children in particular.
A Lifeline in Telehealth
Telehealth is critical to ensuring access to care as the pandemic rages, but many of its fundamental benefits — convenience, flexibility and geographic accessibility — are not unique to the pandemic. It makes sense, then, that experts anticipate the expansion of telehealth will endure beyond the current health crisis.
This is good news for population health. It could also be one of the ways this devastating pandemic ultimately transforms healthcare for the better. Telehealth has the potential to address several long-standing barriers related to social determinants of health, particularly benefiting those who lack reliable transportation or reside in rural and resource-scarce communities.
Affecting Policy. Effecting Change.
Temporary measures by the government have helped to enable the use of telehealth and ensure the delivery of critical healthcare communications during the public health emergency. In effect, these actions are addressing barriers to engagement that existed long before COVID-19 — and, barring permanent reform, will continue to exist in its aftermath.
The Federal Government has made great strides by permanently expanding telehealth coverage for Medicare beneficiaries and pledging to support states in expanding telehealth access for beneficiaries of Medicaid and CHIP. However, to fully realize the value of telehealth in this pandemic and beyond, there must also be a focus on concerted consumer education, including additional federal regulatory changes that enable that education.
Like CMS, the Federal Communications Commission (FCC) took swift action to respond to the pandemic by temporarily alleviating provisions of the Telephone Consumer Privacy Act (TCPA), permitting some COVID-19-related calls and texts from healthcare providers and government officials to consumers without risk of litigation. Under the TCPA’s temporary exemptions, the healthcare community, including HMS, has successfully contacted millions of Americans with COVID-19 education and resources. With regard to HMS’ COVID-19 outreach, 86% of consumers reached said the communications, which included information on accessing available telehealth benefits, were indeed helpful.
Without this temporary exemption, the TCPA, while intended to protect consumers from unsolicited calls, would have impeded these important healthcare communications. A permanent fix to the TCPA for healthcare-related calls is needed as we strive for innovative, patient-centered care.
Adapting, Innovating, Improving
In the context of COVID-19, telehealth promises to keep at-risk consumers connected to their healthcare while staying safe at home; beyond the pandemic, it has the potential to create a more efficient, equitable and consumer-centric healthcare system. A public health crisis has propelled telehealth into the future, but additional policy changes and stronger consumer education are vital to its success.
For more strategies to help states and healthcare organizations navigate the new healthcare normal, browse HMS’ full toolkit of COVID-19-specific population health management and cost containment resources at Health Ideas.