A McKinsey report revealed that nearly 40% of US residents surveyed prefer telehealth services compared to 11% before COVID-19 in the United States. The report also concluded that reimbursement for telehealth is a factor in 84% of providers wanting to continue. While 40 states now have laws requiring telehealth coverage, 22 states have amended their regulations to bring parity in insurance payments for telemedicine and in-person services. See Telehealth.org’s previous articles Telehealth Expansion: 6 Additional States Announce Telehealth Coverage and 7 States Change Telehealth Coverage for Telehealth Reimbursement for more information. However, internet accessibility, speed, and cost continue to hamper the expansion and sustainability of telehealth benefits.
Broadband Connectivity & Technology Access
Though telehealth services provide significant benefits to Americans, the broadband and technology access problems put telehealth’s potential and sustainability at risk. Broadband limitations threaten the lofty promises advanced by telehealth startups, which received a whopping $37.9 billion or 75% more funding in 2021 and are predicted to increase 10-fold to $307 billion by 2028.
The Pew Research Center, which has been tracking internet usage by Americans for the last 15 years, warns that nearly 25% of US adults have no access to broadband at home. It claims that bandwidth is insufficient for a video consultation in large parts of rural America, where about 15% struggle to pay their internet bills. The Census Bureau’s 2019 American Community Survey reported that one in every five seniors lacked internet access. Going into the pandemic, this most-vulnerable age group was most likely to miss out on telehealth access. Supporting the findings of these groups, a full-service survey and marketing research firm known for innovative methodologies and optimized research designs by the name of SQL Server Reporting Services (SSRS) was commissioned by the Bipartisan Policy Center to assess the impact of broadband connectivity. The study’s researchers concluded that limited broadband connectivity and technology access are the two most significant barriers to telehealth services. Researchers in the SSRS report concluded that one in every three adults surveyed had problems accessing telehealth. About 45% of respondents viewed broadband and computer access as pivotal obstacles for video-based telehealth visits. Every third person reported that the lack of high-speed internet impedes telehealth benefits in rural areas.
Reimbursement for Telehealth Internet Bills
The exponential growth of the virtual health industry has caught the attention of insurers. Both public and private telehealth programs are now developing reimbursement programs to pay for online consultations and the internet access facilitating them. For example, Medicaid’s Affordable Connectivity Program expands reimbursement for telehealth to include the broadband benefit for the poorest. Funded by the Infrastructure Investment and Jobs Act, the plan pays every household a one-time credit of $100 to buy digital devices and $30 to cover internet expenses.
Medicare’s Special Supplemental Benefits for the Chronically Ill include subsidies for utilities viewed necessary for general living support. The coverage extends to the internet connection at home. Private insurers also have lower-cost broadband benefits in many of their plans. For instance, Louisville-based Humana has two health insurance plans that promise an annual internet bill payment of up to $1,000. Also, Devoted Health has offered three plans, each paying up to $300 of reimbursement for telehealth to help purchase digital devices or internet services. Similarly, Healthfirst and Wellcare have plans that come with a $125 payment for data use.
Critics See Drawbacks
There is criticism over reimbursement for telehealth internet bills, and many fear that such reimbursement can potentially add to overall health care costs. The lack of infrastructure to support high-speed connections continues to pose a problem. Another concern is the potential overuse of telehealth claims. However, insurers are starting to seriously consider the economies of offering telehealth coverage to avoid hospitalization, drive down liability, and relieve virtual healthcare costs and access.
The Way Forward
Despite a rapid expansion of telehealth in recent years, broadband and technology access problems persist. While only a handful of plans offer to pay for connected devices and internet bills to date, these precedents are growing. A Milliman report forecasts that additional telehealth benefits may be part of at least 94% of Medicare Advantage plans, increasing 36% compared to 2020. Since improving digital access is now recognized as a social determinant of healthy living, healthcare insurers are more likely to incorporate broadband subsidies in their reimbursement for telehealth.