Four policy considerations for the future health of telemedicine

October 28, 2020 — The well-documented explosion of telemedicine and virtual healthcare during the COVID-19 pandemic has further demonstrated its value for patients, providers, health plans, employers and other healthcare purchasers. Usage is up 8,336%* while employer satisfaction with telemedicine vendors is at 95%**.

For telemedicine and virtual care to capitalize on this momentum and take its rightful place in the healthcare ecosystem post COVID-19, however, will require a thoughtful approach from policymakers.

To help guide this emerging treatment protocol, Mercer, the American Benefits Council (“The Council”) and Catalyst for Payment Reform propose four key telemedicine considerations for policymakers:

1 – Make permanent the provision in the CARES Act allowing HSA-eligible high-deductible health plans to cover telehealth services on a pre-deductible basis.

2 – Ensure that an employer’s more robust offer of telehealth services does not result in violations of the Affordable Care Act’s market reforms to the extent the benefits provided give rise to an ERISA health plan and provide significant benefits in the nature of medical care.

3 – Remove state barriers to telehealth care, such as requiring that patients have a pre-existing relationship with the provider and allow licensed providers to deliver services to patients in other states via telehealth.

4 – Reject mandates that would require parity in payments to providers for virtual and in-person services and thereby impede employers’ flexibility to innovate and pursue value-based care.

“Telemedicine’s time has finally come and there is no going back,” said Tracy Watts, Mercer’s US Health Policy Leader and member of the Council’s board of directors. “Thoughtful policy decisions made at this critical time can have an enormous impact on the positive role telemedicine can and should play in the future of the healthcare ecosystem.”

“Employers’ embrace of telemedicine before the pandemic – and even more so since – is a demonstration of the value they add to the health care system and their ongoing commitment to innovation,” said Ilyse Schuman, Senior Vice President, Health Policy, for the American Benefits Council. “We urge policymakers to lead with us by making it easier for employers to deliver this vital health service to employees.”

“During the pandemic, telemedicine has demonstrated its value as a way to improve access to healthcare, while letting health care providers continue to work and make a living,” said Andréa Caballero, Catalyst for Payment Reform Program Director. “As employers and other healthcare purchasers peer into the future, however, they are concerned that continuing to pay the same for telehealth visits as in person visits will not only raise costs but be inappropriate, as certain care can only be provided in person.”

An infographic and white paper that further explain the topics and policy considerations described above are publicly available at https://www.mercer.us/our-thinking/healthcare/telemedicine.html.

*Fair Health’s Monthly Telehealth Regional Tracker, year-over-year utilization increase, April 2020.

**June 2020 Mercer survey of 505 US employers (based on those with sufficient feedback to respond)