Telehealth: Is the Genie Out of the Bottle?

Telemedicine was on  an upward growth curve before this current pandemic, only experiencing explosive growth since the beginning of mass stay at home orders.  What the future holds depends on a few things: how well telemedicine substitutes for the face to face encounter; how adaptable licensed health professionals, insurers, and self-funded employers are  in embracing Telemedicine in the long run; and how economically rational the transition to Telemedicine  may prove to be.

Telemedicine's growth, pre-pandemic, was overwhelmingly in the world of large employer-sponsored health insurance.  https://www.healthsystemtracker.org/brief/more-employers-are-paying-for-telemedicine-but-enrollee-take-up-has-been-relatively-low/ This means the urban-suburban-rural design of these systems will be quite different. This is complicated by the very high rate of uninsured individuals in rural counties.  Telemedicine or F2F encounter, providers are not equipped financially to take on a great many patients lacking insurance as out-of-pocket collection rates can be quite low, quite expensive, etc.  In addition, even in Medicaid expansion states (a group Missouri has very recently joined), Medicaid reimbursement rates are such that few providers can take more than a limited number of such individuals into their patient panels.  Many providers take none at all.  https://www.ky3.com/content/news/Missouri-Medicaid-reimbursement-low-and-slow-creates-boundaries-for-children-with-disabilities-566759491.html

A new law in Missouri expands insurance coverage for disability therapies for children, but many won't benefit because of Missouri's "poor" Medicaid reimbursement rates.

 

Telemedicine – the delivery of health services by providers at remote locations, such as through video conferencing or remote monitoring – has been seen as a way to possibly improve access to care while also lowering costs.  In our 2018 Employer Health Benefit Survey (EHBS), we find that the share of large employers offering health […]

Telemedicine has, in the U.S., been for the insured.  In other countries, telemedicine is available to a much broader swath of the population :  https://www.theguardian.com/australia-news/2020/may/13/the-genie-is-out-of-the-bottle-telehealth-points-way-for-australia-post-pandemic.

'The genie is out of the bottle': telehealth points way for Australia post pandemic | Health | The Guardian

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