Introduction
Telemedicine is a leading innovation that has proven to expedite the delivery of health care. Telemedicine is the use of technology to deliver health care, health information, or health education at a distance. It helps people connect more quickly to their primary, specialty, and tertiary medical needs. Its beginnings trace back to the late 1800s when providers began using the telephone to resolve patient consults at a distance, saving them from making time-consuming house visits. In the age of the internet, these consults involve face-to-face conversations and evaluation via computer screens.
Despite the convenience that telemedicine provides, some medical providers still resist adopting the practice because certain services do not always come with insurance reimbursement. Such pushback is one of the reasons why 43 state legislatures have passed laws governing private-payer telemedicine reimbursement policies, 24 of which require telemedicine payment parity. Telemedicine parity laws force private insurance carriers to pay medical providers for services delivered via telemedicine at the same rate as those delivered during an in-person office visit.
More rigorous evaluation and data are needed to determine the overall impact of telemedicine parity laws on health-care costs, quality, and access. Nevertheless, evidence suggests that these laws may disincentivize the creation of treatment plans that meet the needs of individual patients. They may raise costs and conceal the cost of care from the consumer. Furthermore, they may encourage the overconsumption of health care by paying providers based on the volume of services and not outcomes.
It is promising that lawmakers continue to advance legislation that encourages more medical professionals to adopt telemedicine so that patients can access care without having to travel long distances. To take the next step, legislators should evaluate the impact of licensure laws. Since January 2020, state law has forced physicians in other states to obtain a North Carolina license in order to treat patients located within this state. The genius of telemedicine is that care can be provided at a distance. There is no reason to limit that care to within the boundaries of North Carolina.
Key Facts
- In some cases, telemedicine parity laws may incentivize physicians to adopt telemedicine platforms. However, enforcing such a rule undermines telemedicine’s cost-effective capabilities. A 2022 study published by health-and-wellness provider Everlywell found that telehealth visits cost on average about $40 to $50, whereas an office visit could cost as much as $176.
- As people become more familiar with the concept of telehealth and its use becomes more widespread, more providers have begun incorporating the technology into their practices. During the Covid-19 pandemic, for example, 95 percent of health centers reported using telehealth to accommodate patients.
- As early as the mid-1990s, Blue Cross and Blue Shield of North Carolina (BCBSNC) provided telemedicine benefits for psychiatric care, psychotherapy, health-behavior assessments, and diabetic counseling. Meanwhile, UnitedHealthcare began covering virtual visits for its policyholders in 2015.
- Basic health care can be accessible even when it is not covered by insurance. In 2015, a group of emergency physicians in North Carolina founded RelyMD, an app that offers 24/7 virtual doctor appointments to patients in exchange for a $70 per-visit fee. Patients can seek medical consultation or treatment in the comfort of their own homes via a computer, smartphone, or tablet in a matter of minutes.
- Direct primary care (DPC) physicians incorporate telemedicine into their patients’ monthly membership fees. Phone calls, texts, emails, FaceTime, secure messaging platforms, and specialty consults – the most common uses of telemedicine are all included at no additional cost to the patient.
Recommendations
1. Avoid telemedicine parity laws.
Parity laws set a precedent for state governments to meddle further in private enterprise by forcing insurers to pay for other telemedicine services that are beyond the scope of their original plan design. Insurance companies should not be required to treat telemedicine care the same as in-person care.
2. Recognize the professional licenses of out-of-state medical professionals who are in good
standing.
Licensure barriers limit telemedicine’s growth. North Carolina could increase the use of telemedicine by allowing out-of-state physicians to treat North Carolinians virtually.
