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Texas Should Remove Regulatory Barriers That Impede Access to Telemedicine

By TCCRI Staff. August. 10, 2020

TCCRI’s Health Care & Human Services Task Force met recently to continue its discussion on better leveraging telehealth technology to increase access to health care services across Texas. The meeting brought together lawmakers, policy experts, and trade groups to examine important steps already taken by Governor Abbott and the Texas Legislature to make telemedicine more available, as well as additional policies that should be pursued in the upcoming 87th Legislative Session.

As highlighted in TCCRI’s 2019 Health Care & Human Services Task Force Report, Texas has a long-standing and well-documented physician shortage. Although rural areas are often a particular challenge, the issue of access is not limited to sparsely populated areas. According to the Texas Department of State Health Services’ website, more than 200 of Texas’ 254 counties are classified as whole or partial “health professional shortage areas.” And while some have used the COVID-19 pandemic as a rallying cry for Medicaid expansion, we in Texas have long understood that coverage does not equal access to care. Enrolling more Texans in government-sponsored programs will not ensure that individuals and families get the care they need; however, making telehealth more obtainable can help accomplish this goal.

Though the demand for telemedicine had been increasing prior to the outbreak of COVID-19, the mandatory lockdowns in many areas of the country catapulted telehealth visits to the primary method in which providers saw many of their patients for several months. U.S. News and World Report has been tracking the increase in telehealth utilization during the pandemic and found that between March 2019 and March 2020 telehealth claims increased by an astounding 4,374% nationally, with about 4.5 million Texans utilizing telehealth over the past several months. The types of claims also evolved from what used to generally consist of shorter, post-appointment counseling and follow-up in 2019 to a larger percentage of longer visits 2020. Though telehealth utilization is decreasing as restrictions on medical visits have lessened, there is no question that this treatment modality is here to stay and will play a larger role in how we interact with our providers on a regular basis post-coronavirus.

Our Task Force was joined by speakers from the Texas Association of Health Plans (TAHP), the John Locke Foundation, and the Foundation for Government Accountability (FGA) to provide unique perspectives on what Texas has already accomplished and areas where we can remove unnecessary regulatory barriers that hamper innovation and continue to encourage the increased use of telehealth post-coronavirus.

Much of the discussion at last week’s Task Force meeting delved into the topics discussed in a new report by the Brookings Institution and John Locke Foundation on removing barriers to telemedicine in the age of COVID-19. These issues include identifying current barriers (i.e. lack of broadband access in some areas of the state, existing licensure laws); allowing the practice of telehealth across state lines; increasing the types of providers and sites that may offer telehealth services; eliminating parity mandates between telehealth and face-to-face care; establishing parameters that discourage opportunities for fraud, waste, and abuse; and allowing greater innovation for payers to design benefits and coverage utilizing telehealth. Though it will come as no surprise to those that champion free-market principles, the research presented at last week’s meeting revealed that mandates, including most parity laws, seem to have little impact in driving up anything related to telemedicine except for costs and, in some cases, have a detrimental effect on utilization.

As we continue to research and develop our policy positions related to telehealth over the coming months, we will focus on which broad guidelines should exist in state law and which unnecessary restrictions should be eliminated so that private sector market forces can drive quality and innovation while decreasing costs. Such policies will help establish a strong telehealth infrastructure that will serve the health care needs of Texans far beyond COVID-19.

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