Telemedicine: some good news on costs, but the fight isn’t over

On Monday, the North Carolina Department of Health and Human Services (NCDHHS) released its Report on Telemedicine Study and Recommendations. It’s been a while since we talked about Telehealth, but as a quick reminder:


  • Telehealth has great potential to improve your health. It allows you to connect to a doctor remotely, improving access and convenience.
  • It also can save money: No overhead costs related to expensive facilities, medical equipment, staff, etc.… Just you and your doctor connected by audio and/or video. However…
  • Earlier this year, there was a bill, HB 283, which was going to mandate that doctors receive the same level of payment as with in-person visits (parity). That means you would be required to pay the same for a telehealth visit as an in-person visit.
  • In other words, you’d be paying the same for a visit that has access to all the great staff, equipment and facilities as you would for one that doesn’t. That difference doesn’t improve your health, it simply improves providers’ profits.
  • Worse, a whole lot of telehealth visits end with a recommendation of an in-person visit. That’s two visits you’d have to pay for! If price parity were enacted, we would often be paying double what we would if telehealth didn’t exist.

On the one hand, the report from NCDHHS could go further in accentuating how to keep costs reasonable.  But on the other hand, it doesn’t go so far as to defend parity, so that’s good for our fiscal health.  They recommend further study on the subject. 

Further study and stakeholder input are needed to consider reimbursement standards for private payers. DHHS should further examine the standards of other states and the results of those standards on cost and access.

 Let’s hope that study turns out well for consumers.  Otherwise, a fantastic, innovative, cost-saving tool could turn into yet another poorly designed cudgel to beat more money out of patients. 

A sign that the NCDHHS cares about skyrocketing costs is their recommendation to develop a policy that allows the freedom to innovate telehealth further, and encourage competition by not imposing unnecessary mandates.

As the regulating agency of the insurance industry in our state, DOI believes the following issues should be considered as it may relate to the commercial market:

• Telemedicine regulation in the delivery of Medicaid benefits should not be directly imposed on the commercial insurance community

• A state telehealth/telemedicine policy needs to be fluid enough to evolve with innovation.

• A telehealth/telemedicine policy needs to encourage market competition and allow carriers the flexibility to realize efficiencies.


This fight isn’t over yet.  It will almost definitely be taken up again by the NC General Assembly during the upcoming session, and we will keep you updated. 

Make sure you join the Coalition mailing list to ensure you receive up-to-date information about this and other issues that impact your rising health costs.

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