Bridging the Emerging Digital Divide with Regulatory Leadership and Telehealth Policy

by Timi Leslie

———–, 2019 — As digital healthcare adoption expands, a digital divide between commercial and public payers digital health offerings is emerging. These differences have a profound impact on lower-income and uninsured patient populations’ access to telehealth’s benefits. There is no similar divide in access to online services for any of our country’s 257 million smartphone owners. Anyone who wants to shop online, access their bank account, or find the optimal route to a new location come across very few barriers.

So, why don’t community clinics offer applications to their patients so they can email their doctor, book appointments, renew prescriptions, and access providers from home via video 24/7? Why don’t more Medi-Cal managed care plans offer access to urgent care video visits to their members to avoid costly and timely emergency room visits?

In our experience, many policymakers and regulators still view telehealth as a sub-par option that has less value than in-person care despite numerous studies showing high satisfaction ratings from both patients and providers, and improved clinical outcomes. Unfortunately, this mindset has been reinforced through decades of technology-limiting regulations, and when combined with the comfort of the status-quo, telehealth adoption among California’s public programs is stalled.

With great anticipation, BluePath Health eagerly awaits the draft changes to the Medi-Cal Provider Manual which allow telehealth visits to be reimbursed at the same rate as in-person visits and will go into effect this Spring.   

However, reimbursement parity is just a first step to bridging the digital divide. A sound telehealth policy will require that California:

  • Expands interstate provider licensing and accreditation,
  • Moves away from non-integrated funding streams (like county mental health) that do not account for centered patient care,
  • Incorporates virtual visits into network adequacy standards, and
  • Reforms managed care capitation rate-setting to acknowledge promising investments being made in digital health.

Adoption of successful technology never slows: rather, it accelerates. It is time to act before California’s public health care programs fall even more behind commercial coverage. We are confident that in 2019 we will see more regulatory leadership and virtual-first policy that will close this healthcare digital divide for good.