Audio-Only Telehealth is Crucial to Patient Health Beyond Pandemic

There is little doubt that the pandemic changed health care delivery. The question is for how long? Audio-only and virtual telehealth allowed Community Health Centers to treat many more vulnerable patients throughout the country during COVID, thanks to flexible federal and state policies that spurred the innovation. But unless lawmakers act to ensure these policies continue into the future, millions of health center patients could lose access to care once COVID is behind us.  A NACHC survey reveals that an overwhelming majority of health centers (96 percent) predict patients will have a harder time accessing care and may suffer poorer health outcomes unless flexible telehealth policies are continued. At the onset of the pandemic, health centers rapidly ramped up virtual check-ins, audio-only visits and e-visits for a range of services.  Nearly all, (98 percent) of health centers provided telehealth services at some point during the pandemic to their 30 million patients, compared to only 43 percent of health centers before the pandemic. This increase came from Congress and the Centers for Medicare and Medicaid loosening their pre-pandemic Medicare and Medicaid telehealth restrictions. The flexibilities and boosts in Medicare reimbursement allow health centers to reach more vulnerable patients, lower their rates of missed appointments, and made it easier to treat chronic health conditions among the underserved.

“As mission-driven innovators, health centers reach beyond the exam room to reach patients where they are. Telehealth is a logical accompaniment, if not a game-changer, to expand access to care,” said Ron Yee, MD, Chief Medical Officer of NACHC.  “The need is especially critical in rural America, where hospital closures have forced people to travel longer distances to see a provider. The pandemic forced health centers to adapt telehealth as a tool to stay connected to patients at home.  To reverse progress will adversely impact the health of our patients.”

Many of the telehealth flexibilities will expire with the end of the Public Health Emergency (PHE) unless federal and state lawmakers take action to make them permanent. If that doesn’t happen many health center patients – especially vulnerable seniors and rural residents who have chronic health issues — will fall through the cracks.  Patients who need behavioral health services and suffer substance use disorders – which skyrocketed during the pandemic – are also at particular risk. 

“The COVID flexibilities around audio-only telehealth have allowed health centers to treat many more vulnerable and high-risk patients,” said Sarah Baizer, NACHC Research and Data Manager and survey author. “We had a hunch that audio telehealth has been an effective mode for both health center patients and providers but these findings show what a valuable tool it is for the future of primary care.”

Among those concerned about the future is William Crumpton, Chief Executive Officer of Compassion Health Care, Inc., located in rural Caswell County, NC. “For our patients audio-only telehealth capabilities have been an important lifeline and often the only mechanism for our center to connect with our largely rural and elderly patients, many of whom still have rotary phones in their homes, don’t drive a car, do not have smart phone technology. We can’t leave these patients behind and take away a tool that they have come to rely on to talk to their provider.”

There are nearly 100 bills pending in Congress to make policies supporting audio and virtual telehealth visits permanent.