Telehealth expanded greatly during the pandemic. Now it remains a vital component of healthcare delivery. Insurance companies play a key role in its use because doctors and other health care providers will shy away from telehealth if reimbursements are lower than office visits.
Dr. Lisa Harris, Senior Vice President and Chief Medical Officer at Excellus Health Plan, discussed the current state and potential future of telehealth services from an insurer’s perspective in an interview with WAER’s Kat Kollins
Rapid Expansion of Telehealth During the Pandemic
"Pre-pandemic, we were really kind of limited to what types of options we had with respect to telehealth options," Harris said.
She explained that the pandemic necessitated a rapid expansion of telehealth services, moving beyond audio and email to include video conferencing. This change was essential as "people couldn't get into their clinicians' offices to be seen."
Current Telehealth Coverage at Excellus Health Plan
Currently, Excellus Health Plan covers virtual telehealth visits for most members, “subject to co-pay, deductible, or co-insurance.” Harris acknowledged that while there is a "return to in-person visits," telehealth "is here to stay." She pointed out the challenge of broadband access in rural areas, which can impede face-to-face virtual consultations, though audio options remain available.
Healthcare in Rural and Low-Income Communities
Ensuring quality healthcare in rural and low-income communities is a priority for Excellus, per Harris. "We continue to make sure that telehealth is covered as is, you know, indicated through New York State." This effort aims to provide broader access to telehealth services for these communities.
Financial Aspects of Telehealth Services
Regarding the financial aspects, Harris clarified that in New York State, telehealth services are reimbursed at the same rate as in-person visits. "So, we haven't really seen an impact from reduced rates," she said, dispelling concerns about lower reimbursement affecting service availability.
Engaging Providers and Patients in Telehealth
Excellus is actively engaging both providers and patients to utilize telehealth services effectively.
"We have value-based payment arrangements with many of our primary care providers that are around quality, which includes some of the access to care," Harris explained.
She noted that Excellus partners with a vendor to provide comprehensive telehealth services, ensuring continuity of care.
Regulatory Compliance and Legislative Support
Regulatory compliance and legislative support are crucial for sustaining telehealth services. Harris highlighted ongoing legislative efforts.
"The Energy and Commerce Committee is meeting to extend the Medicare telehealth provisions for another two years to beyond 12/31/24."
She also mentioned a commercial bill in the House working on pre-deductible coverage for telehealth services, stressing the importance of these measures for continued access and quality care.
Encouraging Members to Explore Telehealth Options
In closing, Dr. Harris encouraged members to reach out to their healthcare providers to explore telehealth options. "Doctor Google is not an accurate reference," she cautioned.
"It's important to connect with your clinical care provider to ensure that you get the best possible care treatment for whatever your condition is."
There are many more options available post-pandemic, from the traditional face to face to telephone and telehealth.
Stay Informed
For more telehealth updates, stay tuned to WAER. Excellus is a seasonal sponsor of WAER.
