By Jessica Hall, Marketwatch.com
Telehealth services for Medicare beneficiaries which were slated to end later this month may get a two-year extension that could keep in place the pandemic-era services available to more than 67 million beneficiaries.
Under a funding package released by the U.S. House appropriations committee on Tuesday, Medicare’s telehealth coverage would be extended until Dec. 31, 2027. Policymakers face a Jan. 30 deadline to extend telehealth funding, or coverage that has been in effect since March 2020 will lapse.
“We’ve seen before that even strong, bipartisan proposals can face unexpected hurdles late in the process, which is why it’s important not to take any outcome for granted when it comes to congressional legislation,” said Alexis Apple, deputy executive director of ATA Action and vice president of federal affairs at the American Telemedicine Association. “While this package does not provide a permanent solution, it represents a significant win for … patients who rely on telehealth services across the country.”
Telehealth services help bridge the gap for people for whom transportation or mobility is a problem and in rural areas where doctors may be unavailable. The common types of medical appointments carried out via telehealth range from mental-health visits to dermatological screenings to conversations with a primary-care doctor about cold or flu symptoms or routine concerns.
The telehealth coverage is part of a government funding proposal totaling roughly $1.2 trillion in spending for the departments of labor, health and human services, education, defense, transportation and other agencies. The government faces a shutdown deadline of Jan. 30.
The funding package also comes as new data shows that telehealth services do not result in overuse of medical services, which may help allay concerns about runaway usage and funding problems.
The new findings, published in Health Affairs Scholar by a team from the University of Michigan Institute for Healthcare Policy and Innovation, showed that overall healthcare visits have remained stable or declined over time.
According to the University of Michigan study, among non-surgical medical specialties and mental-health providers, the total number of visits stabilized and even declined slightly through June 2024, the most recent period available to analyze.
That study found that telehealth accounts for 44% of all behavioral health visits and 9% of primary-care visits among beneficiaries in traditional Medicare. The data reflects more than 60 million people who had nearly 539 million appointments during a five-year period.
Telehealth services boomed during the COVID-19 pandemic and handled about 42% of Medicare’s outpatient visits during its height, according to Ateev Mehrotra, a professor at Brown University’s School of Public Health. Volume then had fallen to about 5% as of 2024, according to Mehrotra.
This fall, telehealth coverage was disrupted and usage fell during the government shutdown, Mehrota and co-authors wrote in a new report. The usage rebounded when the government reopened, but any disruption to coverage could affect telehealth usage again.
“Telehealth is no longer a temporary solution; it has become a mainstream part of care delivery,” Mehrota and the co-authors said. “Without congressional action to reinstate telemedicine flexibilities, both beneficiaries and providers will continue to face disruptions in access to care, loss of critical services and wasted investments in telehealth infrastructure.”
Greater telehealth usage leads to fewer emergency-department visits and better medication management among patients, but there’s still an overall cost increase for Medicare. A 2024 study in JAMA said the higher usage of telehealth services led to a higher cost of care of $164.99 per Medicare beneficiary.
Before the pandemic, telehealth was possible only under very limited circumstances in Medicare. If Congress does not extend the services, Medicare recipients in rural areas will still be able to use telehealth services, but only if they are accessing the technology from a medical building such as a doctor’s office or a hospital to speak with a provider located elsewhere.
