Telehealth’s uncertain future

June 24, 2024 10:08 am

THE STATE OF TELEHEALTH — As lawmakers weigh telehealth’s future with broad bipartisan support, it’s becoming clear that it hasn’t yet made the impact on cost and access that some thought it would.

Usage has fallen — to the disappointment of Congressional leaders and the investment and tech sectors, some of whom thought it could fundamentally transform the U.S. health care system.

In 2021, former Rep. Fred Upton (R-Mich.), a leading voice in Congress on health care until his retirement last year, called telemedicine “one of the best things, probably, since sliced bread.”

Now, evidence is growing that telehealth hasn’t delivered the anticipated broad cost savings, and that trend isn’t expected to change soon. In rural areas, which many believed would disproportionately benefit from virtual care expansion, usage has also been lower than in other areas.

“It hasn’t taken off like we thought,” Upton, who chaired the Energy and Commerce Committee, told POLITICO. “It can be [transformational], but progress is not as fast as we thought it could have been.”

Harvard researcher Dr. Ateev Mehrotra, who Congress often calls to testify on virtual care, has found that expanded telehealth has led to slight increases in visits and spending and “modest” improvements in quality.

Still, despite negative headlines and falling stock prices on Wall Street, it’s certainly not all doom and gloom for virtual care. Telehealth kept the health care system afloat in the pandemic’s early days, and it’s continued to broaden access and boosted outcomes in some areas, particularly in mental health and substance use disorder treatment.

Telehealth advocates argue that comparing early pandemic usage levels — when in-person care was limited — to the present isn’t fair. Overall, telehealth appointments represented about 6 percent of visits in late 2023, according to Epic Research. That’s up from 0.2 percent in mid-2019.

“When you’re dealing with a health care system for hundreds of millions of people, any improvement in outcomes is definitionally transformational,” said Sen. Brian Schatz (D-Hawaii), one of virtual care’s longest-running backers. “It’s quietly one of the most important stories in health care in the last decade.”

Outlook in Congress: Lawmakers are poised for a temporary extension of pandemic-era eased Medicare rules but still have questions about cost and fraud and seek more data.

“I’ve never said it’s going to reinvent health care,” said Rep. Mike Thompson (D-Calif.), one of the House’s strongest telehealth supporters. “I have plenty of examples where it’s saved lives and money. … It’s still in that trial phase.”