In the face of a pandemic that forced millions of people to stay home, telehealth has gone mainstream. The number of Blue Cross Blue Shield of Michigan participating physicians offering virtual care has surged from under 10% in early 2020 to over 80% in June. An analysis of national insurance claims indicated a telehealth increase of over 4000% compared to last year. Forrester predicts virtual visits to surpass 1 billion nationwide by the end of the year. The numbers both reflect the scale of the stunning, tragic impact of COVID-19 and reveal an opportunity to expand access to care beyond the pandemic, to turn a grave moment into a tipping point.
New legislation signed Wednesday by Governor Whitmer is helping make sure that the benefits of the technology are here to stay. The bipartisan, five-bill package will expand the availability of telemedicine for Michigan’s Medicaid enrollees, starting in October 2020.
The bills add coverage for appointments that take place at patients’ homes and schools, and they will allow for non-real-time (also called asynchronous, or store-and-forward) visits, adding flexibility for both doctors and patients through the use of recorded videos. Remote patient monitoring will also be covered, permitting doctors to analyze patient data using a monitoring device, giving them access to important information like blood sugar level, blood pressure, and heart rate.
Prior to the pandemic, in order to be covered by Medicaid, Michigan telemedicine visits had to take place in a specific health facility, had to be real-time conversations, and could not involve health monitoring devices.
This legislation, introduced before the pandemic began, solidifies some of the policy relaxation implemented by the Whitmer administration in response to COVID-19. Though this more recent telehealth expansion will likely be of assistance to those impacted by the pandemic, the bills were created for long-term change, not simply as an emergency response.
Policy changes like this one help advance an issue that has been a priority of the Health Fund since our founding—building the strength of Michigan’s healthcare workforce and expanding access to care for residents. Our fast-tracked telehealth awards, announced in early April, were part of our ongoing commitment to the benefits of health technology. And virtual appointments have been particularly useful for older adults, people in rural areas, and those seeking behavioral health treatment, all areas of interest in our grant rounds.
Telemedicine visits can also address transportation barriers, as mentioned in our recent report, and research shows it can cut costs for both providers and patients. With telehealth technology touching a cross-section of so many of the Health Fund’s priorities, supporting its expansion is a no-brainer for us.
That’s not to say that this form of care is without flaws. The Detroit Free Press reported on a few of them. For example, virtual visits aren’t a possibility for those who lack the technology or reliable WiFi access. Many medical tools—EKG machines, blood tests, stethoscopes, etc.—are still only available in doctor’s offices. Despite precautions, privacy remains a concern with any online communication, and the trade-off for convenience can be more impersonal interactions.
Telemedicine isn’t going to replace in-person visits completely, but it nonetheless offers a valuable option for patients, and policy changes like the bills signed today open the door for them to use the tool to its full potential. Expanding access to this treatment within Medicaid means expanding access for some of Michigan’s most vulnerable populations—Medicaid covers 3 in 8 children, 3 in 8 people with disabilities, and 3 in 5 nursing home residents in our state.
As we look forward to the end of this unprecedented health crisis, let’s embrace the ways technology can increase access to care, decrease disparities, cut costs, and improve the health of residents of Michigan as a whole—pandemic or not.