Telehealth is working, let’s keep it that way

Senate bill would provide rate parity for 2 years

COVID-19 HAS HAD a devastating impact on our lives, our healthcare system, and our economy, but one silver lining has been the immediate and dramatic expansion of telehealth services. We’d be foolish not to seize this opportunity to ensure that telehealth access remains a part of routine medical care in the Commonwealth long after the pandemic is over.

Teleheatlh refers to health care services that are provided remotely, typically through videoconference or phone call. It offers a convenient way for patients to access care and consult with a doctor through technology, such as a laptop or phone, that a patient may already own. Telehealth allows patients to essentially take part in a virtual doctor’s appointment—whether it’s using a tablet to snap a photo of your skin to send to your dermatologist for a quick evaluation or having a 30-minute counseling session with your therapist over the phone.

Despite its convenience, telehealth has not been widely utilized in Massachusetts. In fact, Massachusetts lags behind other states. According to the latest DataPoints issue released by the Massachusetts Health Policy Commission on March 12, the rate of telehealth use in the Commonwealth in 2017, the most recent year for which data exists, was 39 percent lower than the national average.

Prior to the implementation of COVID-19 social distancing and stay-at-home advisories in March, only 8 percent of residents said they had consulted with their doctor through phone or video, according to a Blue Cross Blue Shield of Massachusetts/MassINC coronavirus tracking survey. That’s because insurance companies were not required to cover most telehealth services—even if insurance would otherwise cover the same health care service if it were conducted in-person.

The COVID-19 pandemic has changed all of this.

At the start of the pandemic, Massachusetts immediately required insurance companies to cover telehealth services to ensure that patients could continue to receive care without visiting a doctor’s office and risking exposure to the coronavirus. Now that we’re several months into the pandemic, it is clear that telehealth increases access to care and is an invaluable tool in the efficient delivery of health care.

The impact of telehealth is profound. To put this in perspective, Blue Cross Blue Shield of Massachusetts recorded 770,000 telehealth visits in May, compared with 5,000 in February. Mass General Brigham is currently conducting 250,000 telehealth visits per month, up from 1,500 in May. According to data from the latest Blue Cross Blue Shield of Massachusetts/ MassINC coronavirus tracking survey, telehealth usage rose by more than 200 percent between mid-March and early April and during that same time period, the share of residents who say they have used telehealth since the onset of the pandemic increased from 8 percent to 21 percent.

Telehealth has the ability to expand access to care, enable faster diagnoses and treatments, improve the efficiency of care, and reduce patient stress. Telehealth is effective now and it will be effective long after a vaccine is developed to treat COVID-19, but there is no time like the present to ensure that telehealth continues to be widely utilized by patients throughout the Commonwealth.

And the state Senate has introduced legislation to accomplish just that.

The Patients First Act, recently filed in the Massachusetts Senate, requires insurance carriers, including MassHealth, to cover telehealth services in any instance where the equivalent in-person service is covered. The bill also embraces an expansive definition of telehealth services, including care through audio-only telephone calls to assist those patients who may not have access to a smart phone, tablet, or computer.

Meet the Author

Karen Spilka

Senator, Massachusetts Senate
Meet the Author

Cindy Friedman

State senator, Massachusetts Senate
Audio-only telehealth services are a vital tool to reduce healthcare access disparities among vulnerable and disadvantaged populations, including those with low income, the elderly, communities of color, those with behavioral health conditions, and people living in geographically isolated areas without internet access. The bill further requires that telehealth services be reimbursed at the same level as in-person health care services over the next two years to ensure the continued expansion of these services.

Finally, to address concerns related to the potential cost of telehealth services on our healthcare system, the Patients First Act requires the Health Policy Commission to monitor the impact of telehealth on the system, recommend ways to maintain access, and ensure that it is sustainable for providers, payers, and – most importantly – consumers.

Karen Spilka is the president of the Massachusetts Senate and Cindy Friedman is the Senate chair of the Joint Committee on Health Care Financing.