Teleheath: Will it Stick Around and Shape Policy in Georgia

Among the Trump Administration’s last efforts before it exited the White House and the Biden Administration entered was finalizing the permanent expansion of Medicare telehealth services and the release of the Centers of Medicare and Medicaid Services (CMS) Annual Physician Fee Schedule, which added services to the telehealth reimbursement list. Does this mean the high utilization of telehealth is here to stay, even with the change in politics?  

Over the last year, telehealth has exploded in Georgia and all over the United States unlike it has before, all due to the COVID-19 pandemic keeping people at home and away from hospitals and doctor’s offices.  

On March 18, 2020, CMS shared recommendations with the nation during a White House Coronavirus Press Briefing that any elective non-medical procedures should be delayed. Medical care for individuals, unless an emergency, was basically put on hold. By this time, more than a few patients were showing up to hospitals and emergency rooms, including those in Georgia, with fever, shortness of breath, fatigue, and other symptoms of COVID-19.

Shortly after, CMS released their Non-Emergent, Elective Medical Services, and Treatment Recommendations, which included recommendations to use telehealth where possible. Many doctors, nurses, and other allied health professionals changed their healthcare delivery overnight. Offices that still operated with 20th century technology installed updated systems that could be used for telehealth, and front office staff quickly learned how to use the technology and trouble shoot telecommunications issues over a phone. Additionally, CMS also began reimbursing for certain set of medical procedures via telehealth that were not previously covered. According to FAIR Health, there was a 3000% increase in telehealth claims from November 2019 to November 2020.

Telehealth in Georgia boomed like it never had before. So much so that during this past legislative session, the Georgia General Assembly passed House Bill 307 which changed provisions of the Georgia Telehealth Act, including allowing health care providers and patients to participate in telehealth services from home. It also prevented insurers from placing additional requirements for telehealth, such as requiring in-person visits first.

However, telehealth was not new to the state of Georgia. In 2005, the Georgia Telemedicine Act was enacted that required commercial insurers to cover telemedicine services. Then in 2014 after two years of evaluation and discussions, the Georgia Medical Composite Board established rules and regulations that set minimum standards for providing treatment and consultations through telehealth.

So the question is … now that the number of vaccinated people are increasing and the number of COVID-19 cases are down, will people still use telehealth in place of traditional visits?

It definitely appears this way. More and more companies are investing in telehealth as investment opportunities. More recently is Walmart, which acquired MeMD, a top telehealth company started in 2010 that allows an individual to start a virtual visit on-demand, and Amazon, which rolled out Amazon Care, a telehealth platform for employees of Amazon and other companies that enroll.  

There are however hurdles that could curb the growth that is expected in the telehealth industry, and it would likely take policy changes to address these. These include lack of access to broadband in all parts of the state and payment parity for telehealth on a federal level. (Georgia did pass a payment parity law for telehealth in 2019, but it only applies to fully funded ERISA plans, the plans that can be regulated by Georgia law). Another challenge is ensuring telehealth is conducting in compliance with HIPAA’s patient privacy laws. As more hurdles arrives, policy makers will need to make policy changes that address these.

Despite the challenges, it is likely telehealth will continue to build momentum and shape healthcare delivery for years to come. Unless needing an in-person visit, many will continue to log in to a platform and visit with our providers virtually, all without having to leave the comfort of our homes and workplaces. In this way, COVID-19 has shaped healthcare forever.