The COVID-19 pandemic has been devastating, but it has forced several emergency health care reforms. One of the most significant and beneficial to patients is a greater use of telemedicine. This can increase access to health care at a reduced cost.

People living in certain geographic areas in the United States lack access to primary and specialty health care. These are mostly people living in rural areas where patients have no timely access to doctors, nurses, or other medical professionals. Nearly 59 million Americans nationally and 1.2 million Washingtonians live in areas with a shortage of access to local primary care. (here)

 Telemedicine, defined as “the remote diagnosis and treatment of patients by means of telecommunication technology,” is gaining popularity and offers a practical solution for lack of health care services in rural areas. Telemedicine allows patients to remain in their own town, or even their own home, and receive direct care from a distant provider.

 The Washington Legislature passed a series of bills from 2015 to 2017 that define who can use telemedicine, where the patient must physically be to receive the consultation, and what the reimbursement is for the provider. The Legislature also established a “Collaborative” where participating institutions could share information and results of the effectiveness of telemedicine practices.

Problems with telemedicine include the licensure of doctors who provide services across state lines and reimbursement parity with in-office visits.  In May 2017, Washington state officials signed on to the Interstate Medical Licensure Compact which allows for state licensure applications to be expedited for out-of-state doctors. However, the state where the patient resides retains oversight of the doctor-patient relationship. On March 25, 2020, Washington state officials declared that providers of telemedicine visits would be reimbursed by insurance companies at the same rate as in-office visits.

Last week, the Trump Administration ruled that out-of-state physicians could provide telemedicine services for Medicare patients, be reimbursed, and be protected from liability considerations. In addition, the Center for Medicare and Medicaid Services released an updated fee schedule for Medicare providers that includes 60 telemedicine services. (here)

These are steps in the right direction to increase access and decrease medical costs for patients. Because of state licensure issues, Congressional action may be required to make these regulatory rulings permanent. Expanding the use of telemedicine is a definite free market heath care reform measure.