Policy Analysis

More states are increasingly making use of telehealth to fill provider shortage gaps and ensure increased access to specialty care. Due to the coronavirus pandemic, many states started advocating for telemedicine to lessen the spread of the disease and ease pressure on healthcare (Volk et al., 2021; Weigel et al., 2020). Higher reimbursement rates for certain services encourage healthcare providers to deliver the service and facilitate increased access to that service, whereas lower reimbursement could have the opposite effect. Expansions on telehealth services could improve general access to health care in Los Angeles, California. Additionally, Medi-Cal beneficiaries, the majority of whom are low-income and with various complex needs, are likely to benefit from the increased convenience brought about by telehealth services. A permanent extension of particular telehealth flexibilities is expected to result in improved access to health care for Medi-Cal beneficiaries. The comfort of getting care for patients and delivering care for the providers can also be enhanced with increased reimbursement.

However, lower reimbursement rates are likely to discourage providers from making telehealth visits available at comparable levels to the service offered in person. Telehealth modalities like live-video telehealth have proven clinically effective for the treatment of various conditions (Legislative Analyst’s Office, 2021). Providing telehealth services is likely to be more attractive than giving in-person services due to the probable superior convenience and the potentially lower expense of delivery. Suppose providers are going to obtain high reimbursement rates for telehealth services in comparison with service delivery expenses. In that case, providers are likely to choose to provide telehealth services even when in-person care could be more appropriate. This is likely to have a negative effect on the quality of care. Such incentive effects need to be considered in setting reimbursement rates for telehealth services.

References

Legislative Analyst’s Office. (2021). Analysis of the Governor’s Medi-Cal Telehealth Proposal. https://lao.ca.gov/Publications/Report/4430

Volk, J., Palanker, D., O’Brien, M.,& Goe, C. (2021, June 23). States’ Actions to Expand Telemedicine Access During COVID-19 and Future Policy Considerations. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2021/jun/states-actions-expand-telemedicine-access-covid-19

Weigel, G., Ramaswamy, A., Sobel, L., Salganicoff, A., Cubanski, J.,& Freed, M. (2020, May 11). Opportunities and Barriers for Telemedicine in the U.S. During the COVID-19 Emergency and Beyond. Kaiser Family Foundation. https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/

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How do U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?

Policy Analysis

LOS ANGELES CA
BOOK: Patton, Zalon, Ludwick Chaps 5 & 6

Expectations
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last five years

GovTrack.us (2019). S.787—115th Congress: Telehealth Innovation and Improvement Act of 2017.
National Telehealth Policy Resource Center: https://www.cchpca.org/resources/news
Telemedicine Regulations in California (2019). Chiron Health.
Wicklund, E. (2019). CMS at ATA: Medicare coverage of telehealth will take some time. mHealth Intelligence.
American Telemedicine Association (2019). Policy updates.
American Telemedicine Association (2019) State of the States reports: Coverage and reimbursement.