Summary
The COVID-19 pandemic has reshaped the role of telehealth in the U.S. health care system. While the Medicare telehealth benefit remained largely unutilized prior to the pandemic, the need for health care amidst the COVID-19 shutdowns rendered telehealth the only viable option for many beneficiaries to access care.
To make access to telehealth available to all Medicare beneficiaries, the federal government exercised emergency waiver authority to temporarily remove statutory restrictions to Medicare telehealth coverage during the ongoing Public Health Emergency (PHE) period, including allowing beneficiaries to access telehealth services regardless of their geographic locations or site of care (such as the home).
However, Congress must pass legislation to formally waive these statutory restrictions if such flexibilities are to remain in effect once the PHE concludes. Over the past year, federal lawmakers have deliberated on whether and to what extent Congress should make telehealth available to Medicare beneficiaries post-COVID-19. They remain largely divided on whether the telehealth flexibilities should continue on a provisional, time-limited basis to allow for greater study of the effects of broad telehealth access, or whether Congress should make these flexibilities permanent.
While much of these federal deliberations touch on the equity implications of telehealth reform and how they would impact communities of color, less of the national discourse has focused on equity as a means for assessing the reforms in question. As such, the Wynne Health Group developed an issue brief to systematically examine the health equity implications of potential Medicare telehealth reform. This resource aims to serve as a preliminary starting point to facilitate equity-centered discussions on how such reforms could impact communities of color.
Specifically, this resource applies an equity assessment framework to the following five Medicare telehealth proposals:
- Removing statutory geographic and originating site restrictions;
- Payment parity (between telehealth and in-person services);
- Audio-only visits;
- Access to broadband; and
- The Medicare telehealth services list.
In brief, our analysis finds that expanded coverage of telehealth services under Medicare stands to address racial and ethnic health disparities. However, certain policies, or features of policies, are needed to ensure that Medicare beneficiaries from minority backgrounds can meaningfully access care via telehealth.