By NextBestFitPermanent telehealth coverage
Cover telehealth at parity across state lines with a national license for telehealth.
Fast access, especially mental health.
Review ledgerHow this path connects
This path
Permanent telehealth coverage
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Cover telehealth at parity permanently
- Create interstate telehealth licensing
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Health professional shortage areas
Covering telehealth across state lines with a national telehealth license offers quick, low-cost access to clinicians.
- Mental health care is hard to get
Telehealth coverage across state lines offers quick, low-cost access and works especially well for mental health care.
What it creates or worsens
- Solves only part of the problem
Telehealth cannot substitute for hands-on care. Telehealth expansion is limited by the lack of broadband in many rural areas.
- Fraud and improper payments
Expanded telehealth coverage carries a risk of fraud.
Who's affected
Who gains
- Rural residents
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- Low- and middle-income households
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- Residents of areas with too few health professionals
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- People needing mental health care
- Mental health care is hard to get: Shortages and limited insurance acceptance make mental health treatment hard to obtain.
- Family caregivers and affected families
- Mental health care is hard to get: Shortages and limited insurance acceptance make mental health treatment hard to obtain.
- Hospitals, clinics, and care organizations
- Mental health care is hard to get: Emergency departments board psychiatric patients who cannot access other care.
- Fraudulent operators and cybercriminals
- Fraud and improper payments: Fraudulent providers receive improper health payments.
Who loses
- Cash-pay and private care practices
- Mental health care is hard to get: Limited insurance acceptance supports cash-pay treatment.
- Health insurers, brokers, and their shareholders
- Mental health care is hard to get: They benefit from avoiding behavioral health costs.
- Taxpayers and public budgets
- Fraud and improper payments: Fraud and improper payments consume public funds and premiums.
- People with employer coverage
- Fraud and improper payments: Fraud and improper payments consume public funds and premiums.
Other ways to soften the losses
- Fund broadband and local telehealth access points
Where it has been tried
- U.S. pandemic waivers: Telehealth use rose sharply and stayed above pre-pandemic levels.
- United States: Medicare fee-for-service telehealth visits rose from about 840,000 in 2019 to 52.7 million in 2020 during pandemic coverage waivers.