In remote areas, gaining access to essential healthcare can be difficult. Until the 2020 pandemic, individuals who lived in cities or large towns with sufficient healthcare may not have seen value in telehealth. However, things changed when the pandemic urged everyone into their homes and healthcare was no longer accessible – regardless of location.
Telehealth was the solution to keeping both patients and doctors safe while providing excellent healthcare. Patients and doctors could be in the same town and still meet for critical appointments. Alternatively, patients and doctors could be miles away, but people received the same care.
Unfortunately, telehealth care is a topic of extensive division. While advocates for healthcare for all know that telehealth is a tool as critical as a stethoscope, other groups disagree. There are technical, clinical, and administrative issues surrounding accessible telehealth.
- Less than ideal information or a perpetuation of misinformation provided to patients.
- Questions around territory or cross-border care – can providers provide care outside of their jurisdiction.
- Care provided by less qualified or untrained individuals.
- Bias towards individuals who are the best connected.
- Lack of emergency support to ensure care.
- Bias towards individuals who are already connected.
- User’s reception of developing telehealth technologies.
Telehealth’s Biggest Hurdle
Appropriate oversight, resource allocation, and regulation can resolve most of these issues. However, the biggest hurdle is that telehealth is a widely unaccepted visit type for many insurance and Medicaid/Medicare providers. In fact, many providers won’t provide telehealth because there’s no clear reimbursement in comparison to traditional appointment opportunities.
When insurance companies and Medicaid/Medicare do accept telehealth services, it is often at a fraction of the price of a traditional visit. Providers then become resistant to providing telehealth options because they aren’t paid enough to accommodate these services.
So, what’s the solution?
On January 14th 2022, House Bill 265 (HB265) was put forward by Representative Spohnholz as “An Act relating to telehealth; relating to the practice of medicine; relating to medical assistance coverage for services provided by telehealth; and for providing for an effective date.” This bill is an extensive and detailed proposal of how telehealth can best be served to help Alaska.
HB265 tackles issues like who can provide care and definitions of care providers while also providing a scope of practice. Critically, HB265 sets forth a discussion of reimbursement so there is no question as to who will pay for these services or if there will be enough payment rendered to justify these services.
Specifically, this bill suggests:
“Regulations calculating the rate of payment for a rural health clinic or federally qualified health center must treat services provided through telehealth in the same manner as if the services had ben provided in person, including calculations based on the rural health clinic or federally qualified health center’s reasonable costs or the number of visits for recipients provided services. The department may not decrease the rate of payment for a telehealth service based on the location of the person providing the service, the location of the eligible recipient of the service, the communication method used, or whether the service was provided asynchronously or synchronously (Emphasis added).”
This bill would effectively increase Alaskans’ access to care. It resolves many of the arguments put forward by those who oppose telehealth.
In Bethel, AK, for example, Alaskans board planes and boats to get to their nearest health center and hospital for care and treatment. If providers widely accept and provide telehealth services, many of the expenses generated by healthcare visits could be avoided. Bethel isn’t the only town or village in Alaska that necessitates travel to access healthcare.
HB265 is the first step forward in making timely and effective change to telehealth services across Alaska. And making telehealth services accessible is a critical step to increasing care for Alaskans – no matter where they are.