Before March 2020, telehealth was not used much in the U.S. Only about 15% of doctors used it in their practice. Health centers also had limited telehealth, with only 43% offering it in 2019. When COVID-19 started, and people had to avoid in-person visits, this number jumped to 95% of health centers providing telemedicine.
This quick growth happened because federal and state policies changed fast. Rules about where telehealth could be used, needing approvals, and initial in-person visits were relaxed. For example, Medicare and Medicaid removed distance rules so patients could get care from home. These changes helped keep care going when visiting clinics was risky or not possible.
North Carolina shows how policies changed fast with careful planning. Before COVID-19, Medicaid in North Carolina only covered a few telehealth visits, so very few Medicaid and CHIP patients used it.
When the pandemic began, the North Carolina Department of Health and Human Services (NC DHHS) removed limits like distance and site rules. Patients could have telehealth visits from home. More services were covered, such as dentistry, care around childbirth, mental health, chronic disease care, and counseling. Payments for telehealth were made equal to in-person visits to encourage providers to use it.
NC DHHS also created a team to quickly make and put policies into action while protecting patient privacy and safety. This team worked with medical groups and community organizations to help providers and share information.
Important lessons from North Carolina for healthcare leaders include:
Telehealth grew a lot, but not everyone had equal access. In North Carolina and other states, Black and Hispanic Medicaid and CHIP patients used telehealth less than others, even in cities and rural areas. Older Medicaid patients and those in rural places also used it less.
Reasons for these differences include problems like poor internet access, especially in rural areas. Also, some doctors did not offer telehealth options to Black and Hispanic patients as often. This might mean some providers were unaware of their biases or did not consistently offer telehealth.
To fix these gaps, some policies were made to:
Healthcare leaders should focus more on diversity, equity, and inclusion (DEI) when building telehealth programs. IT teams must make sure technology is easy to use, especially for patients not comfortable with digital tools.
During the pandemic, telehealth helped manage chronic illnesses. Diseases like type 2 diabetes and opioid use disorder need regular check-ups and medicine management. Telehealth let patients get care without risking exposure to the virus.
Mental health care also used telemedicine a lot. With social distancing, many felt isolated and stressed. Telehealth mental health visits kept growing even when other telemedicine visits went down after the first wave of the pandemic. Laws that made telehealth payments equal to in-person visits and fewer restrictions helped many behavioral health providers treat patients by video or phone.
Remote patient monitoring and eConsults improved care further. For example, eConsults let primary care doctors get quick advice from specialists like dermatologists without a patient needing to go in person.
This shows telehealth is not meant to replace in-person care but to help. Healthcare leaders should offer hybrid care that mixes virtual and face-to-face visits, based on what patients need.
Even though telehealth grew fast, there are still rules that make it hard. Most U.S. states require doctors to have a license in the state where the patient is located. Some states have special telemedicine licenses to help, but not everywhere. This makes it harder to provide virtual care across state lines.
Telemedicine payments also vary. Many states passed laws to pay telehealth visits like in-person visits during the pandemic. But some private insurance companies have started to reduce telehealth coverage, especially for care not related to COVID-19. This could make doctors less willing to offer virtual visits.
Healthcare administrators and IT managers should keep track of changing state licensing rules and payment policies. They need billing and compliance systems that can work with different state laws as telehealth changes.
The rise of telehealth showed the need for ongoing training for healthcare providers. For example, North Carolina created several programs:
These programs help with problems like changing how work is done, telemedicine manners, privacy rules, and ways to engage patients. Medical administrators and IT teams need to support ongoing training to keep telehealth care good.
The pandemic sped up not only telehealth visits but also home-based care. This means things like remote patient monitoring, virtual disease prevention and management, and working with caregivers.
Studies from organizations like Landmark Health and Ascension showed home-based care:
Changes in rules helped these services grow beyond small tests. It is suggested that these federal and state policy changes be kept permanent.
Healthcare leaders should combine home-based care with telehealth. IT systems must be safe, follow privacy laws like HIPAA, and work with remote devices and patient data sharing.
Artificial intelligence (AI) and automation are becoming more important in telehealth. Providers deal with many calls, scheduling, patient triage, and tasks like billing and paperwork.
Companies like Simbo AI make phone automation tools using AI that help telehealth offices. These systems answer calls, send them to the right person, and work all day without tiring staff. AI automation can:
For healthcare administrators, using AI tools can make operations smoother, reduce staff tiredness, and improve patient satisfaction. IT managers play a key role in setting up these tools with electronic health record (EHR) systems and telehealth platforms.
AI also helps make telehealth fairer by supporting multiple languages and helping patients who are not familiar with digital tools using simple voice commands.
The COVID-19 pandemic made telehealth a much bigger part of healthcare in the U.S. This happened because policies and technology changed quickly. However, access and coverage differences still matter.
Healthcare leaders should work on:
Following these lessons can help medical administrators, owners, and IT managers keep telehealth useful and fair in healthcare delivery in the U.S.
The main focus of the webinar is to explore how telehealth can support equitable access to health care for Medicaid populations, addressing the challenges faced by those in rural and under-resourced communities.
The pandemic spurred increasing usage of telehealth, improving access to care for individuals who faced barriers in visiting providers’ offices.
A key challenge is the digital divide that can lead to inequitable access to telehealth benefits, particularly among Medicaid recipients.
The target populations include patients in rural and frontier areas and individuals living in under-resourced communities.
The purpose of the panel discussion is to share policy and practice-level strategies to enhance telehealth access for Medicaid patients.
Panelists include Sachin Shah, MD, from University of Chicago Medicine; Jenny Azzara, MM, from Community Care Cooperative; and Christopher Chen, MD, from Washington Health Care Authority.
Chelsea Bodnar shared experiences on how telehealth was used to increase access for pediatric patients in rural and frontier areas.
The agenda includes follow-up sessions and webinars to continue discussing strategies to strengthen primary care through Medicaid Managed Care.
Telehealth policies emerged rapidly during the pandemic to support ongoing patient engagement and care delivery amid healthcare access challenges.
The overarching goal is to ensure equitable access to healthcare services, improve health outcomes, and enhance patient engagement through innovative telehealth practices.
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