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Telehealth Emerging as a Key Resource in Fight Against Coronavirus

April 03, 2020

Telehealth Emerging as a Key Resource in Fight Against Coronavirus

By Travis Singleton


In the 2018 Survey of America’s Physicians that Merritt Hawkins conducted on behalf of The Physicians Foundation, approximately 18% of doctors indicated they practice “some form” of telehealth. However, of that 18%, the considerable majority (73%) indicated they derive 10% or less of their revenues from telehealth.


Both those numbers have increased significantly since then, and are very likely to have doubled. Telehealth, already an increasingly important channel for expanding access in traditionally underserved areas, is emerging as a key resource in the fight against coronavirus and its use is growing exponentially. 


The federal government recently recognized this fact by expanding telehealth services for Medicare beneficiaries.


Effective March 6, CMS will pay for office and hospital telehealth visits to various providers, including physicians, nurse practitioners, clinical psychologists and social workers. Telehealth visits will be reimbursed at the same rate as in-person visits and can take place in a range of settings, including nursing homes, hospital outpatient departments and the patient’s home. 


We have heard from a wide range to clients that their patient requests and sign-ups for telehealth options have gone through the roof. Even if just a portion of these continue to use telehealth for initial care in the long-term, it will transform how frontline care is delivered.


Further easing the process, some federal HIPAA requirements will be relaxed, so that physicians can deliver telehealth services with their personal phones. Physicians also will have more discretion regarding patient co-pays, so that cost won’t be a barrier to care. 


These are all welcome steps, as Medicare policy has restricted telehealth delivery in the past, limiting payments to services provided in rural areas and in local health care settings, rather than homes. As is typical with any new technology or delivery pathway, when reimbursement catches up to utilization and demand, use of the technology/pathway increases dramatically.


Expanding access to telehealth acknowledges the reality that health care providers are not distributed evenly across the U.S. The federal Health Resources and Services Administration (HRSA) now designates over 7,000 Healthcare Professional Shortage Areas (HPSAs) nationwide – about twice the number it designated 15 years ago, many of them in rural and inner city areas. Telehealth provides a means of bringing healthcare professionals who may have extra capacity to HPSAs and other areas where there is a particularly pronounced need.  


Just as traditional care in many HPSAs has been fragmented and sporadic, so has telehealth delivery. These changes will likely spur the industry to a more mature status, from small, regional players to larger, more national ones engaged in heated competition. 


In a pandemic like the one we are now experiencing, telehealth also has the key advantage of protecting both the health professionals who provide care and the patients receiving it, as neither party comes in personal contact with the other, and it saves much needed medical supplies such as masks. Some services can take place in the home, so patients don’t have to travel and potentially expose others to viruses or be exposed themselves. It also makes it easier for physicians who have retired but maintained their licenses (of which there are many) to get back into the workforce and help where they are needed. We have seen a significant increase in the number of physicians who have never considered telemedicine who now are providing at least some care through this growing delivery channel. This meets today’s need for safety in the short-term, but also matches the long-term need many doctors express for a more controllable schedule and a better quality of life. 


The net effect of telehealth is to expand the flexibility and mobility of healthcare professionals, increasing net FTEs without increasing the actual number of physicians, advanced practitioners and other clinicians in the workforce (though we need to do that, as well).


Much the same thing can be accomplished through interstate licensing compacts that would allow physicians, nurses, and advanced practice professionals to travel from one state to another without having to obtain a license in each state. Reducing barriers to care that are created by current licensing requirements is another step the Trump administration may soon take. One positive emerging from the pandemic is the rapid innovation that is taking place where technology is being incorporated into the routine delivery of care.


This will materially change how patients access the healthcare system, with both mental health and radiology being the bellwhethers, since reimbursement for telehealth was first applied in those specialties. Merritt Hawkins has created a white paper entitled Telehealth: The Integration of Telecommunications into the Patient/Provider Encounter that addresses the origins of telehealth, its applications, payment policies and related matters and you can download it here


It is to be hoped that the coronavirus epidemic will be addressed as quickly and efficiently as possible, and that, on the other side of the crisis, we will have innovated our way to healthcare system that is more flexible, responsive and accessible to all patients.




Travis Singleton is Executive Vice President of Merritt Hawkins, a company of AMN Healthcare, the largest healthcare staffing organization in the U.S. and the innovator of healthcare staffing solutions. He can be reached at travis.singleton@merritthawkins.com.


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