John Locke Update / Research Brief

As Senate GOP Fumbles Health Reform, Telemedicine Delivers Better Access To Health Care

posted on in Health Care, Health Care & Human Services
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This week, the Senate GOP made a major fumble on health reform. The good news, however, is that we can look at how market forces and the states have already been working to make health care access more convenient, price transparent, and affordable.

Telemedicine, for example, is a multibillion dollar industry and a leading innovator in the health care arena. Defined as “the use of technology to deliver health care, health information, or health education at a distance,” telemedicine helps people connect faster to their primary, specialty, and tertiary medical needs. Patients can submit questions about non-urgent health issues and receive responses from a distant medical provider within hours without having to sacrifice quality of care. Online eye exams are just as accurate as an in-person optometrist appointment, and renowned Centers of Excellence are partnering with rural hospitals to assist in monitoring their intensive care units (ICUs).

Telemedicine’s ability to expedite the delivery of care has proven to fill in some of the health industry’s pervasive gaps, such as the ongoing rural provider shortage. The Health Resources and Services Association (HRSA) reports that 20 percent of Americans reside in rural areas, and just 11 percent of the nation’s physicians practice rural medicine. North Carolina alone has documented 145 primary care shortage areas across the state.

That’s when telemedicine apps like RelyMD come in to cover this void. Founded in 2015 by an independent emergency physician group in North Carolina, RelyMD’s board-certified physicians offer 24/7 virtual doctor visits to their users in exchange for a $50 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. Not only is RelyMD convenient for a busy parent with a sick child who cannot wait an average 19 days to be seen in-person by a family physician, but the cost is also a significant discount compared to an urgent care visit or a minimum $1,000 trip to the ER. Other apps that offer similar services at varying price points are Teladoc, LiveHealth Online, DoctorOnDemand, HealthTap, and more.

RelyMD is now working with North Carolina’s community health centers to extend after-hours care when these facilities are closed. The partnership began in 2016 with Piedmont Health’s Scott Community Health Center in Burlington, NC. One year later, RelyMD expanded its presence and is currently available to patients who frequent all ten of Piedmont’s locations that are spread across the central region of the state.

Large employers see the value in telemedicine as well. According to the Wall Street Journal, surveys highlight that 75 percent of firms offer telemedicine services as an additional benefit option for their employees. North Carolina’s Onslow Memorial Hospital and Well Care Home Health have done so with the state’s home-grown telemedicine startup – a potential way to reap in savings on health care claims and enjoy greater workforce productivity.

Patients want more of this, stat. Market research shows a 20 percent increase in the use of virtual visits from 2015-2016. And for others who are not familiar with telemedicine, surveys indicate that they are open to seeking this method of care for multiple reasons, namely less travel time for minor ailments and not having to take off work for an in-person appointment. The uptick in demand has also driven insurance companies to embrace telehealth coverage. In 2015, UnitedHealthcare began offering virtual medical provider visits to their policyholders. Meanwhile, Blue Cross and Blue Shield of North Carolina has covered telemedicine services for psychiatric care, psychotherapy, health behavior assessments, and diabetic counseling as early as the mid-1990s.

But even if insurers didn’t cover such benefits, price-transparent telemedicine companies are marketing the fact that basic health care doesn’t have to be expensive when paid for out of pocket. Congress should at least agree on this point and permit states to let their carriers appeal to more policyholders by offering products that don’t always include ‘excessive’ benefits.

In spite of whatever Congress does or doesn’t do, telemedicine continues to reach and care for more patients. And states are finding solutions to advance the industry’s footprint even further. In 2014, the North Carolina Medical Board revised its position on telemedicine so that physicians could prescribe medications to a patient virtually without being required to conduct an initial in-person exam. This past week, Governor Roy Cooper signed off on pivotal legislation that will allow nurses to obtain a single, multi-state license so they can deliver telehealth to out-of-state patients. The Interstate Medical Licensure Compact, sponsored by the Federation of State Medical Boards (FSMB), is also working to expand telehealth by expediting the process for physicians to become licensed in Compact states.

All of these initiatives are enabling telemedicine to spread scarce resources to patients in both underserved and urban areas. As telemedicine continues to evolve, it’s inevitable that there will be more laws regulating the booming industry. Hopefully, reason will prevail, and governments at every level will do everything they can to let the telemedicine market run unfettered.

Katherine Restrepo is the Director of Health Care Policy at the John Locke Foundation. Before joining the John Locke Foundation, she interned at the Cato Institute under the direction of Michael Cannon, Director of Health Policy Studies. … ...

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