According to the American Hospital Association (AHA) in 2019, even though Medicare has made incremental improvements in coverage and reimbursement it is not sufficient. In addition, they see limited access to broadband services, cross-state licensure, online prescribing, privacy and security, and fraud and abuse as challenges to the widespread use of telehealth delivered services. However, since then COVID-19 has changed some of the landscape and addressed some other challenges as well.
COVID-19 has raised virtual care to a “must-have” strategic priority for providers to provide safe access to care. Virtual care was projected to grow to a $55 billion global business by 2025, with 17% compound annual growth rates from 2020-2025. COVID-19 will only amplify that growth as historical barriers to widespread telehealth adoption begins to crumble.
These barriers include:
Historically, many physicians resisted widespread adoption of virtual care for fear their services would be diminished or replaced. There was also a notion that telehealth may only be appropriate for minor conditions but not for the regular patient panel. They were also concerned about medical errors, privacy and security of PHI, and lack of integration with workflows. As more physicians and patients are forced to try telehealth, resistance is waning.
Pre-COVID, uncertainty around insurance coverage and reimbursement for telehealth slowed adoption. Similarly, the red tape and other regulatory barriers have been daunting, including requirements for provider licensing and credentialing and privileging.
During COVID, CMS in the U.S. moved quickly to give healthcare providers more flexibility in implementing telehealth. More than 80 additional services were approved for delivery, with CMS matching payment rates for virtual visits with in-person appointments.
The administrative burden on cross-state licensure and credentialing requirements has also been reduced as well. CMS is reviewing whether these loosened requirements will remain in the future.
Pre-COVID, more healthcare leaders were designating virtual care technologies as a means to optimize workforce potential, expand access to care, and improve customer experience. Concurrently, niche and fragmented virtual technology offerings were becoming more relevant to providers. The pandemic has pushed hospitals and healthcare systems to hardwire telehealth as the new future. Consumers are demanding convenience, access, and affordability that will define the new future of healthcare.
Pre-COVID, a survey in 2019 found that only one in ten consumers had used telehealth-based services and that nearly 75% of respondents lacked access to or were unaware of telehealth options. Since COVID, consumers are more apt to try virtual care. A survey in March 2020 reported that 73% of respondents said they would consider using a telehealth service to be screened for COVID-19, while 60% said the pandemic has increased their willingness to try virtual care.
Market drivers and emerging trends within the US create a ripe environment for maturing and expanding virtual care (Kammer & Antush, 2020). These include:
The AHA supports the expansion of telehealth services and advocates for the following: