During the COVID-19 pandemic, telehealth grew quickly as healthcare systems tried to keep patients connected while lowering chances of infection. This change was especially important for Medicaid patients. They often have problems like no transportation, no local doctors, or strict work hours.
Telehealth offers several benefits for Medicaid patients:
These benefits can help improve health and make patients happier. For example, doctors like Dr. Chelsea Bodnar in Montana have used telehealth to care for children in rural areas, showing telehealth can work well where services are limited.
Even though telehealth can help, a big problem remains — the digital divide. This means some people do not have computers, smartphones, good internet, or the skills to use them well. This problem affects many Medicaid patients, especially those in rural places, with low incomes, older adults, and some racial or ethnic groups.
Studies of over 10,500 Medicare patients aged 65 and older found that Black non-Hispanic and Hispanic seniors, those living in rural areas, and poorer people are less likely to have digital devices or internet. This makes it hard for them to use telehealth, which often needs video and internet.
Many Medicaid patients have similar issues. In rural areas, internet providers may not offer enough speed for video calls. Older adults and people who don’t know much about technology find new tools hard to use. These problems limit telehealth use for people who need it most.
Experts like Dr. Sachin Shah from the University of Chicago Medicine say policies must improve to fix these gaps and support fair healthcare for Medicaid patients.
Besides technology, rules and payments also affect telehealth for Medicaid patients. Different states have different policies on who can offer telehealth, what services are allowed, and how providers get paid. These differences affect how easy it is to get telehealth care.
For example, some states only allow certain kinds of providers to offer telehealth or require special licenses for doctors working across state lines. These rules make it harder to expand telehealth for Medicaid Managed Care programs. The Ryan Haight Act controls how doctors can prescribe controlled medicines by telehealth. Normally, patients must be seen in person first, which can limit care for people with mental health needs.
Medicaid payment rules also vary. The Bipartisan Budget Act of 2018 helped pay for remote patient monitoring, but there are still differences in paying for video visits versus phone calls. Areas with poor internet may use phones more but do not get paid the same for these services.
These rule and payment differences make telehealth uneven for Medicaid patients.
Mental health is an important area where telehealth can help Medicaid patients, including kids and young adults. The Biden administration wants to make behavioral health care easier to get because many people with mental health problems do not get treatment or get poor care.
Medicaid programs like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) offer chances to screen mental health and make referrals. But crisis mental health services usually do not have enough funding and are separated between Medicaid, Medicare, and private insurers.
Experts such as Richard G. Frank and Sherry A. Glied suggest improving telehealth for mental health by making sure networks are good enough and closing the digital divide. They also say paying for mobile crisis units and stabilization via telehealth could make critical care easier for Medicaid patients.
Clinics can lend or help pay for devices for low-income patients. They can team up with local groups to teach digital skills. Offering training or help desks for patients new to telehealth can boost use and satisfaction.
Working with local internet providers, governments, and nonprofits to improve broadband in rural and poor areas is important. Some states have programs to build internet infrastructure or lower costs for Medicaid patients. Clinics should support these efforts.
Because not everyone has good internet, providers can offer phone visits when video is not possible. They should push for Medicaid to pay for these phone visits to keep care going for those without internet.
Medical practice leaders should work with Medicaid MCOs that often run telehealth and community programs. MCOs might have money for patient education, devices, or transport help related to telehealth.
Tracking telehealth use by patient type, location, and visit type (phone or video) can show gaps and help fix them. Teams should check patient results, experiences, and how active patients are to improve telehealth services.
Tools using artificial intelligence (AI) can handle routine calls, scheduling, and reminders. This lowers work for staff and helps patients get information on time. For example, some companies use AI for phone answering and call handling so staff can focus on medical care. Patients find it easier to book telehealth visits this way.
AI can help before visits by using chatbots or voice systems to gather patient info. This can help find patients who need urgent care, especially in mental health or long-term illness care, so resources get used well.
AI can study telehealth use data to find out which Medicaid patients use telehealth less and why. This helps leaders reach out better and change policies as needed.
AI can offer real-time translation and voice recognition to help patients who don’t speak English well or have disabilities take part in telehealth visits. This helps improve communication and reduce barriers.
Automation can make documentation and billing easier and more accurate during telehealth visits. AI tools help make sure privacy rules like HIPAA are followed while making work smoother.
By using AI and automation carefully, medical clinics can improve telehealth flow, reduce missed appointments, and make services better for Medicaid patients.
By knowing challenges Medicaid patients have with technology, clinics can plan telehealth services that are fair and last over time.
This information is important for clinics that serve Medicaid patients in the U.S. Understanding and fixing the digital divide in telehealth can lead to better care, healthier patients, and more steady use of healthcare. Using technology solutions and automation can help clinics provide good care to all Medicaid patients, no matter their access to technology.
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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