Beyond Response to COVID-19, It’s Time to Permanently Remove Barriers to Telehealth

Telehealth is critical right now, as the health care system grapples with provider shortages and we work to reduce in-person contact. But, it was also measurably improving health outcomes before the crisis started.

Now is the time for lawmakers at every level to massively expand telemedicine’s availability for all Americans by permanently removing the last roadblocks that have been holding back its promise.

Telehealth is a natural solution to get people help quickly and without contact, including for increased mental health issues like anxiety and depression. Efforts to combat coronavirus have included huge steps from state and federal officials to make telehealth more accessible than ever before.

The administration expanded Medicare coverage for telehealth services, and more than 14 states took action to eliminate barriers. For example, Massachusetts ordered insurers to cover medically necessary services over the phone, and New York waived cost-sharing, deductibles, copayments and coinsurance for in-network telehealth visits.

When coronavirus subsides, lawmakers will have to ask themselves: Should we go back to the way things were before? The answer is no.

I believe telehealth works best as a complement to in-person care. While some visits, such as a pap smear or inserting an intrauterine device need to be done in person, telemedicine can help patients quickly and conveniently renew birth control or talk to a mental health professional.

We know telehealth can help improve health outcomes, solve access issues for hard-to-reach populations, and even reduce costs. Yet we have been slow to resolve several barriers to widespread implementation.

First, we need to permanently solve coverage issues that prevent providers and patients from adopting telehealth. Even when telehealth is covered, providers are nervous that claims will not be reimbursed appropriately.

Uncoordinated policy changes, variability in coverage, and billing and coding uncertainty have prevented broad uptake. To solve this, insurance companies should post and regularly update their policies for telemedicine in a single, central place to reduce administrative burden and doubt.

One example here is breastfeeding support. A provision of the Affordable Care Act mandates that insurers completely cover the costs of breast pumps and lactation consultants, but the execution of this provision has been spotty.

Advantia’s Pacify app provides on-demand, 24/7 lactation and other post-natal support through video calls. The problem? Insurance companies have been slow to cover tele-lactation — just as they’ve been slow to adequately cover lactation support in general.

Practicing across state borders is another issue we need to permanently resolve. Most states require that doctors be licensed to specific requirements to practice medicine inside their borders.

This red tape has been lifted for in-person visits during this coronavirus outbreak so that doctors can quickly travel where they are most needed, but the problem still exists for telehealth providers. While there are unique legal and medical circumstances in each state, we need to catch up with cross-border licensing and create a system that works both in-person and online.

For people in rural communities, there is another significant barrier to telehealth access: internet access. One of the greatest benefits of telemedicine is that it increases access to health care for patients that are the most vulnerable: the differently abled, the elderly, and people in rural communities.

Before the coronavirus pandemic began, 2019 was the worst year for U.S. rural hospital closures in a decade. These same struggling hospitals will soon likely be completely overwhelmed by coronavirus patients. Internet access — and telehealth access — must be expanded in underserved communities.

At the same time, we absolutely need to maintain high standards for security and privacy. The administration waived several privacy requirements under the Health Insurance Portability and Accountability Act to expedite access to telehealth in response to the coronavirus. These protections should be restored at the end of this national emergency.

Earning public and patient trust is essential to consumer adoption and the long-term growth of the telehealth industry. We can and must invest in scalable platforms that meet regulatory guidelines and protect patient privacy while providing secure and trusted care.

We know telemedicine works. A recent study of Advantia’s Pacify app found that mothers using the app were 1.5 times more likely to be breastfeeding at three months and two times more likely to be breastfeeding at six months. One Pacify partner reported a 26 percent decrease in unnecessary emergency room visits among patients using the app. These promising results show how telemedicine can significantly improve health outcomes and help lower costs.

Telehealth will save lives during this pandemic. It can also help answer dozens of health care problems in better times. There has never been a clearer mandate for lawmakers to take decisive steps to increase access to telemedicine. Breaking down the remaining barriers permanently will make us better prepared for the next crisis and improve health outcomes in the meantime.


Sean Glass is the chief executive officer of Advantia Health, a national provider of women’s health care offering telemedicine to all its patients.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Morning Consult