Debate sparks over cost of telemedicine

Though different health plans will take different approaches, overall, doctors will likely — as they did before the pandemic — get paid less for most telehealth than what they do in person. And players in the industry are divided over whether that will make care over phone and video rarer again.

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April 14, 2021 - 8:09 AM

Ansel Armstrong had just found a psychologist when COVID-19 turned the world upside down, forcing in-person care to go remote.

So video sessions replaced a 40-minute drive between Lawrence and Topeka.

“I love how much it frees up my schedule,” Armstrong said. It eased the process in other ways, too. “It’s like, you’re at home. I have my cat on my lap. I think it was a less stressful experience.”

A wide range of medical and mental health care weathered the forced exodus from bricks and mortar to the online realm during the pandemic. Many patients appreciated the convenience. Many doctors found it effective.

Government and private insurers mostly embraced the switch and, in light of the crisis, paid physicians and other providers the same for an online visit as an office exam.

But that will change after the pandemic. Though different health plans will take different approaches, overall, doctors will likely — as they did before the pandemic — get paid less for most telehealth than what they do in person.

And players in the industry are divided over whether that will make care over phone and video rarer again.

Patients don’t all want telehealth, but the vast majority want to keep the option on the table.

“They like it,” said Jennifer Findley, a vice president of the Kansas Hospital Association. “They like it and they want it to continue.”

Meanwhile, whether traditional health care providers in Kansas offer remote services or not, major out-of-state companies that specialize in offering it at lower rates will do so. And that will give local providers a run for their money.

When the pandemic hit and doctors, clinics and hospitals had to go remote for as much care as possible to save lives, it forced a range of piecemeal changes to telehealth rules.

They involved a head-spinning array of largely temporary actions by federal and state agencies, legislatures, governors and private companies, each of which affected different sections of the nation’s complex insurance market — Medicare, Medicaid, federally regulated large employer plans and other kinds of state-regulated commercial insurance — in different ways.

Just a few examples:

Federal and state rules relaxed to let people on Medicare and Medicaid get care from home and to allow more Medicare telehealth outside of rural areas that were previously the focus.

It became easier to get a prescription without setting foot in a doctor’s office, or to talk to a doctor in another state.

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