A study conducted by the Reason Foundation, Cicero Institute, and Pioneer Institute revealed that the US states have room for improvement in advancing telehealth policy to ensure better access to high-quality care. The COVID-19 pandemic has caused a significant shift in healthcare delivery, leading to the widespread adoption of telehealth services. The study noted that while telehealth services were available before the pandemic, millions of Americans used telehealth for the first time over the past three years. The researchers found that most of the emergency actions taken early on in the pandemic were only temporary, and as public health emergency declarations ended, and executive orders were withdrawn, many of the new flexibilities were lost.
The study identified four areas in which states can improve their telehealth policies. The first area is Modality Neutral, which refers to allowing different types of telehealth services, not just live video. The researchers recommended that state laws and regulations should define telehealth in broad terms that do not favor one mode of telehealth over others or preclude future innovation in care delivery. This includes allowing for asynchronous or synchronous technology and remote patient monitoring technology, by a health care practitioner to a patient or a practitioner at a different physical location than the health care practitioner.
The second area is allowing patients to Start Telehealth by Any Mode. Allowing the relationship to be initiated through the patient’s preferred modality is essential, the study found. This means removing any barriers that get in the way of jump-starting a telehealth relationship. State laws and regulations should not prohibit patients from initiating a relationship with a telehealth provider via their preferred modality.
The third area is No Barriers for Patients to Across State Line Telehealth. The study highlighted that allowing patients to access providers outside their community is imperative as most cities and towns lack certain kinds of providers. This ends geographic and economic discrimination for many patients and allows access to providers who would not otherwise be accessible by distance or expense of travel. The study recommended that states should allow providers in good standing to see patients in another state without jumping through expensive, time-consuming hoops.
The fourth area is Independent Practice, which refers to the scope of practice for nurse practitioners (NPs). The researchers found that expanding the supply of health care professionals with high-quality nurse practitioners is a necessity, given the acute shortage of doctors projected to grow up to 124,000 by 2034. Expanding NPs’ scope of practice increases access to care and reduces costs without compromising quality. The study rated each state based on whether NPs are allowed to practice in the way they have been trained, or if the state still requires a doctor to provide oversight or co-sign their work.
Overall, the study recommended that states refocus their efforts to ensure clear laws and guidelines are in place for innovation to emerge, so that patients and providers can benefit from telehealth services. The researchers emphasized that immediate action is needed to avoid disrupting patient access to providers they gained during COVID as other options may not exist in their community. The study’s authors called for adoption of their state policy agenda for telehealth innovation to remove deleterious barriers that have historically discriminated against those in certain geographies, such as rural communities or underserved urban areas.