Medicare’s coverage of a broad range of services is slated to end when the coronavirus no longer poses a public health emergency. Private insurers, which followed the federal government’s lead, could revert to paying doctors for virtual visits at a fraction of the cost for traditional visits, if anything at all.
“The concern everyone in the industry has is that reimbursement is in jeopardy,” said Dr. Mia Levy, the director of the cancer center at Rush University Medical Center in Chicago, which treated patients virtually during the height of the pandemic.
On Monday, President Trump described telehealth as a “very, very big priority” after he signed an executive order aimed at making permanent some of the changes in Medicare policy that his administration adopted during the pandemic. The order focuses in part on finding ways to ensure access to medical care for people in rural areas.
While there is broad bipartisan support for telehealth coverage, Congress would have to pass specific legislation to make some of Medicare’s changes permanent. Some lawmakers favor permanently expanding Medicare payment for a broad range of telemedicine services, but others are concerned about the technology’s cost and potential for fraud.
Many patients enjoy the convenience of telemedicine. And it is particularly valuable for those vulnerable to the virus, like Susan Varak, 45, who has breast cancer. “I don’t think it’s absolutely necessary to be face-to-face every couple of weeks,” she said.
But for some patients, telemedicine is not a substitute for in-person care. Jorge Cueto, who is in his mid-20s, said a virtual visit is often an additional step before going to the doctor’s office for, say, a sore throat.
“It’s another fee, it’s another gating mechanism,” he said.
Dr. Ateev Mehrotra, a professor of health care policy at Harvard Medical School, argues that the goal of telemedicine should not be to lower health care costs over all. One of its main benefits, he said, is improving patients’ access to care, adding that it would be foolish to expect savings if more people also get treatment. “Those don’t reconcile,” he said.