An Analysis of State and Federal Telehealth Reforms During and Beyond Covid-19

R Street Institute: An Analysis of State and Federal Telehealth Reforms During and Beyond Covid-19

R Street Institute, a nonprofit, nonpartisan, public policy research organization issued a report of the changing trends in telehealth policies during the pandemic and recommends solidifying flexibilities related to audio-only telemedicine services, store-and-forward data services and medical licensure. This report echoes suggestions made by the Alliance for Connected Care and over 230 other groups in a recent letter sent to governors urging them to maintain and expand licensure flexibilities through the end of the federal public health emergency. The report makes the following recommendations:

Consider audio-only telehealth expansions. Audio-only telehealth became accessible in all 50 states and Washington, D.C. during the pandemic. Now, as evidence emerges on where audio-only telehealth is most useful–particularly for rural and low-income areas without broadband access–policymakers should consider which pandemic-era audio-only policies helped these communities the most, and ensure state regulations allow for them.
Make specific allowances for store-and-forward telehealth to take better advantage of its full potential. Especially in states with rural and remote communities, store-and-forward telehealth can greatly complement synchronous telehealth and traditional in-person care. For urban areas, store-and-forward telehealth provides greater convenience and flexibility for patients and physicians alike and eases the need of taking time for appointments. Thus, more states should move towards legislation that reimburses store-and-forward telehealth. To do this, patients, physicians and legislators must be assured that asynchronous telehealth is a safe modality that can protect a patient’s personal information, and is a sufficient means through which a patient-physician relationship can be established.
Enhance flexibility for patients and providers located in different states. Telehealth facilitates the connection between patients and providers regardless of the geographic distance, but states are slow to adopt permanent cross-state licensing reforms with the same regularity as audio-only methods. Policymakers looking to expand telehealth should consider state restrictions on medical licenses, and look to join licensure compacts or eliminate in-state license requirements.