Telehealth at the Intersection of SDoH

Two years later, there are some changes to telehealth.

We all remember the day the locks were removed for telehealth to come flooding through the doors and into everyone’s household as a mechanism for healthcare delivery. In the darkness of the COVID pandemic, patients could have covered access to their physician from the comforts of their own home.  Prescriptions were electronically transferred to the pharmacy or delivered via mail order right to your door. The companies and options for services seemed overwhelmingly easy and we probably all wondered how long is this going to last?

While Medicare has agreed to continue telehealth approved coverage through December 2023, individual states may have already started putting in restrictions for when the public health emergency (PHE) ends. It will be important for hospitals and health systems to stay up to date with their state regulations. Key changes that are occurring across the country in various states, include the possibility for patients needing opioid management through drugs such as buprenorphine will be returning to in-person only visits. Also, depending on your state, patients would only be able to access telehealth services from in-state licensed providers or states that acknowledge reciprocity agreements for physicians. That means that a patient seeking medical care may have to go back to only seeing physicians within state lines and could no longer have a virtual visit with a physician in another state, unless that physician holds a license in the same state.  

 In Hawaii, House Bill 1980, is proposing limitations on audio-only visits with recommendations that audio-only services be used when all other options have been exhausted. We will have to see how that is going to be operationalized. Last month, CVS announced that they will no longer be accepting prescriptions for controlled substances from telehealth companies Cerebral and Done Health. The clash originated after the companies were criticized with concerns for over-prescribing controlled medications, such as Adderall.

Finally, in the growing abortion debate, telehealth companies that provide services to women across state lines and deliver mail order medication could significantly be restrained with the new abortion laws and the reversal of Roe vs. Wade.

So, what does this mean for the patient, not all telehealth is going away and at least for Medicare many options are still here to stay. However, the free for all that we once enjoyed of full access to any provider across the country via virtual means is going to be a little bit harder to access.

Programming Note: Listen to live reports on the social determinants of health every Monday on Monitor Mondays, 10 Easter.

References:

‘Untreated’: Patients with opioid addiction could soon lose access to virtual care – POLITICO

Telehealth licensing requirements and interstate compacts | Telehealth.HHS.gov

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Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

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