CBO analysis paints pros and cons of telehealth

The Congressional Budget Office identified telehealth as one of the tools to help reduce prices paid by commercial health insurers in a recently released policy analysis. 

The paper noted both positive and potentially negative consequences, something that might not please proponents of the technological efficiency 

Policies that could decrease costs by regulating price growth, encouraging competition, and boosting price transparency were laid out in “Policy Approaches to Reduce What Commercial Insurers Pay for Hospitals’ and Physicians’ Services.” It said that lowering prices paid for commercial insurance would improve financial outcomes for many privately-insured patients, but cautions that physicians’ pay could drop, and patient access and quality of care could suffer.

Clinicians, including many long-term care stakeholders, agree that telehealth was a success story in the government’s pandemic regulation response. The Centers for Medicare & Medicaid Services expanded access to the technology that allowed therapists and physicians to remotely help residents at a time when quarantining was widespread and crucial. Healthcare advocates want Congress to make the pandemic expansion — set to expire 151 days after the public health emergency ends — permanent.

CBO dedicated one section of its paper to telehealth’s place in the potential policy-related reduction of costs. 

“The recent shift toward more generous insurance coverage of telehealth services increased some patients’ access to care,” authors noted. “Maintaining those changes would expand the pool of patients who could use telehealth services, thus encouraging more providers to incur the fixed costs of investing in the necessary technologies and increasing the number of providers competing, in person and virtually, in each market, which could reduce prices. Those effects on prices could be greater if they were coupled with policies that promote cross-state licensing for providers.”

However, because policies to broaden coverage of telehealth would expand the capacity of the healthcare system, they could also increase the volume of services provided to both privately and publicly insured people, offsetting some or all of the savings from any potential reductions in prices paid to providers.

Allowing for interstate licensing for providers so they could virtually treat patients in different states, CBO said, is another way to increase the cost savings associated with telehealth, noted a report in Inside Health Policy. AHIP, an advocacy group for healthcare coverage and providers, said in a white paper concerning telehealth that it recommended against continued payment parity between in-person and telehealth appointments. It said states can accept telehealth’s cost-saving traits by not mandating the same rates for telehealth and in-person visits. AHIP also encouraged moving toward value-based care models for telehealth.