Report: Progress on telehealth adoption by states, but still wide variation

Rebecca Vesely

About Rebecca Vesely

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health, science and medicine for AFP, the Bay Area News Group, Modern Healthcare, Wired, Scientific American online and many other news outlets.

The American Telemedicine Association (ATA), a leading trade group for telehealth providers and advocates, this week released its first report since 2017 that tracks state policies on telehealth.

Telehealth adoption is growing, and more states are embracing policies that improve coverage and reimbursement for telehealth services, according to the report. Lack of reimbursement mechanisms has been one of the biggest barriers to telehealth adoption.

Among the key findings in the report:

  • Forty states and the District of Columbia have adopted policies or received award funding to improve coverage and reimbursement of telehealth services.
  • Private payer parity in telehealth visits and removing restrictions on where patients can receive telehealth visits were two of the most common issues taken up by statehouses in recent years.
  • Twenty-one states and the District of Columbia mandate that Medicaid offer coverage for telehealth services the same as in-person visits.
  • Thirty-six states and the District of Columbia regulate private payer telehealth coverage, with 16 states requiring payment parity with in-person visits. Of these, 12 states have changed policies since 2017.
  • Six states have adopted or updated telehealth policies since 2017 on what types of technologies can be used to deliver care, including Kentucky, Maine, Utah, Oregon, New Jersey and Massachusetts.
  • Twenty-two states and the District of Columbia cover remote patient monitoring but the coverage varies widely, and by disease state or health condition.
  • Twenty-nine states don’t specify where a patient must be physically located in order to receive care via telehealth. Of those that do specify the site of origin, 12 states recognize the patient’s home as the originating site, and 12 states and the District of Columbia give the same standing to schools.
  • Sixteen states limit telehealth coverage to real-time technology (excluding other types like store and forward).
  • Seven states cover audio-only telehealth, including Maine, Alaska and Oregon, which helps to extend access to patients and providers who may prefer to connect by phone, or for rural areas where broadband connectivity can be a challenge to implementing video visits.
  • States are increasingly using telehealth to fill provider shortage gaps and extend access to specialists. Alabama is the only state that identifies physicians as the only provider type that can deliver care via telehealth.

Ann Mond Johnson, CEO of the ATA, said in a statement that the report should be used as a tool to highlight states “that are excelling at advancing telehealth policy, and the barriers and opportunities which vary widely across the policy landscape.”

To obtain a copy of the report, contact Amy Gaddis at ATA at agaddis@americantelemed.org. The ATA has a slide deck available on request to explore state-by-state regulations on telehealth.

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