Telehealth is Here to Stay…So What Should That Look Like?

February 08, 2021

One silver lining that’s come from the COVID-19 pandemic is the meteoric rise of telehealth usage. 

Telehealth – or healthcare that’s delivered virtually over phone or video – is a remarkable tool that has the potential to vastly expand access to care and significantly lower costs. 

But there is a big thing that could mess it up: costly and dangerous government mandates from the North Carolina General Assembly. 

There are two kinds of mandates that pose a threat to telehealth’s potential in a post-COVID 19 world. 

The first is a cost mandate. This would force you to pay the exact same for an in-person doctor’s visit as you would for a virtual doctor’s visit. 

The second is a coverage mandate. This would force you, through your insurance premiums, to cover (i.e. pay for) any healthcare service provided virtually if it’s covered in-person. 

The Cost Mandate Problem

The problem with the cost mandate is that totally erodes any of the potential cost savings that telehealth could achieve for patients by mandating that it stays in the pockets of hospitals and providers.

One of the main benefits of telehealth is that it is a more cost-effective option for care. You don’t need traditional office equipment. There isn’t check-in staff. You don’t use any of the utilities or other in-person services that come along with in-person care. 

A cost mandate forces consumers to pay for the brick-and-mortar expenses that they simply don’t use during a telehealth visit.

If your car needed an oil change, would you expect to pay the same amount to a mechanic who does it for you in-shop as you would for one who tells you how to do it yourself over the phone? No. Your car isn’t taking up a space in their shop, you’re using your own oil and tools, and doing the labor yourself. 

A virtual oil change would cost the mechanic less than an in-shop oil change, so you’d expect those savings to be passed onto you. 

The same is true with telehealth. It doesn’t cost the same as in-person care to provide. Those savings shouldn’t be pocketed by multi-million-dollar healthcare facilities. They should be passed on to the consumer. 

The Coverage Mandate Problem

The problem with the coverage mandate is that it ignores some of the very real and practical limitations of telehealth. 

Are there places where insurance coverage for telehealth makes sense? Of course. Behavioral health and primary care are two key areas where virtual visits can be utilized with high-quality and effectiveness. And if these services are just as effective virtually as they are in-person, then covering them and paying equal makes sense. 

Are there also places where mandating that your insurance premiums cover telehealth doesn’t make sense? Yes. 

Virtual surgery is just one example that illustrates how preposterous such a mandate would be. 

You wouldn’t think anyone would try to perform virtual surgery, no matter how minor. But who knows? 

What about drawing blood virtually? This is another dangerous suggestion, but if the government mandates it must be covered (and providers must be paid for it), then it doesn’t seem so far-fetched. 

Even in areas like physical therapy or dermatology, it’s hard to match the quality of in-person care with a phone call or video chat. 

None of this changes the fact that telehealth is a remarkable tool that we should fully embrace to expand access and lower costs. 

It simply recognizes two basic things. 

First, the savings should be passed onto consumers. 

Second, there are commonsense limitations on the quality of care that can be provided virtually. 

Telehealth, when done right, has the potential to vastly change healthcare for the better. 

We can’t let government mandates mess that up.


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