Telemedicine widens scope of services amid pandemic, but payment parity looms large

By: - December 12, 2020 7:54 am

Dorothy Hughes said study of telehealth usage in Kansas indicated largely positive outcomes from loosened restrictions amid the pandemic. (Noah Taborda/Kansas Reflector)

TOPEKA — The consensus opinion among health care professionals indicates telehealth services have opened new avenues toward better patient outcomes across Kansas, but many providers fear the loss of current reimbursement rates could force them to cease these services.

Early in the pandemic, Gov. Laura Kelly issued an executive order expanding access to telehealth by reducing regulations. Among those changes was expanded reimbursement and payment parity through Medicaid for certain services.

Dorothy Hughes, assistant professor at the University of Kansas School of Medicine, presented Wednesday findings from a study indicating broad support for telehealth and the flexibility allowed by these policy changes.

“Most of our respondents said that either they’re having some positive or very positive experiences with telehealth,” Hughes said. “We also asked about policy priorities going forward, and payment parity came out on top.”

The study, conducted by the United Methodist Health Ministry Fund and the KU School of Medicine, showed widespread support from health care providers for opportunities provided by telehealth. It also indicated a need to continue payment parity.

Of the 231 providers who responded fully to the survey, more than 60% said allowing decreased geographic restrictions on care had a somewhat or significant impact on their ability to provide care. And 85.3% indicated expanded reimbursement had a positive impact.

More than 60% said the reimbursement rate before COVID-19 did not cover costs. Amid altered pandemic restrictions, only 38% of providers reported telehealth reimbursement rates were worse than in-person rates.

In turn, 61.5% of respondents said payment parity was the top policy issue in ensuring the continued best use of telehealth.

“Telehealth is not intended to replace in-person care,” said David Jordan, CEO of United Methodist Health Ministry Fund. “However, payment parity was central to the ability to expand services, which is why providers in the survey highlighted that this is the top issue for them as they move forward and work to figure out sustainability and services.”

David Jordan, CEO of United Methodist Health Ministry Fund, said payment parity would be crucial for continued access to appropriate telehealth services. (Noah Taborda/Kansas Reflector)

Providers partaking in the study expressed great interest in using telehealth services beyond the pandemic. Increased usage of these services could push state legislators to consider requiring KanCare, the state’s Medicaid system, or private health insurance companies to reimburse at the same rate as in-person services.

Rep. Brenda Landwehr, a Wichita Republican and chairwoman of the KanCare Oversight Committee, said pay parity would likely receive some pushback.

Legislators discussed a similar adjustment three years ago, but insurance companies complained. In 2018, the Legislature passed a telehealth bill mandating coverage parity, which requires payors provide the same level of insurance coverage for patient services but not payment parity.

“It’s a can of worms. When you open it, it explodes in this building,” Landwehr said. “I’m not discouraging, but it’s just not going to be a slam dunk because a survey said.”

Landwehr said the pandemic has forced the issue of telehealth into the spotlight. She said similar conversations were taking place among legislators on the Special Committee on Mental Health Modernization and Reform.

“COVID has also advanced a lot of positives and telehealth happens to be one of them,” Landwehr said. “It was moving there, but it’s escalated now, so how do we deal with that?”

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Noah Taborda
Noah Taborda

Noah Taborda started his journalism career in public radio at KBIA in Columbia, Missouri, covering local government and producing an episode of the podcast Show Me The State while earning his bachelor’s degree in radio broadcasting at the University of Missouri School of Journalism. Noah then made a short move to Kansas City, Missouri, to work at KCUR as an intern on the talk show Central Standard and then in the newsroom, reporting on daily news and feature stories.