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Telehealth's year in review: 5 trends in state policies

January 26, 2017

    Many states across the country made significant changes to their telehealth policies in 2016, particularly around coverage expansion and standards for using telehealth to enhance care delivery. To understand how the telehealth policy reforms from the past year will impact your organization in 2017 and beyond, look to these five trends:

    1. Parity legislation requiring equal reimbursement for telehealth is becoming the norm

    Increasingly, states are implementing parity laws that require some payers to reimburse telehealth services to the same extent as in-person services. Our most recent count showed 31 states and DC with private payer parity laws and 20 states and DC with Medicaid parity laws.

    In 2016, six states either passed a new parity law or had a parity law go into effect. With a number of additional states considering similar laws, expect parity to gain traction in 2017.

    Graph 1

    2. More than a third of states have signed onto the Interstate Medical Licensure Compact

    In October 2016, Pennsylvania became the most recent state to sign onto the Interstate Medical Licensure Compact, which aims to expedite out-of-state physician licensure across participating states. The addition of Pennsylvania means 18 states have now joined the Compact.

    The Compact is building its administrative process for expedited licensure. That means that while interstate licensure is not available yet, it could be soon.

    Graph 2

    3. Rules for a patient's location (the "originating site") during telehealth encounters are becoming more flexible

    Patients' homes and schools can increasingly serve as authorized originating sites for reimbursable telehealth interactions. In 2016, Hawaii, Minnesota, and Washington all expanded reimbursement for real-time, audio-visual virtual visits where a patient is at home, and Hawaii and Missouri expanded reimbursement for virtual visits where a patient is at school.

    In the past, many states have also required patients to be in rural areas in order for a telehealth service to be reimbursed. These rural restrictions for reimbursement ended in Colorado and Minnesota in 2016 and are no longer in effect in Hawaii as of January 2017. Rural restrictions will end in Arizona in January 2018.

    Graph 3

    4. New telehealth modalities beyond live video visits are being added

    Of the three core telehealth modalities (live-video interactions, remote patient monitoring, and store-and-forward services), live-video has historically been the focus of most states' telehealth policies. Nevertheless, there's a push to include more remote patient monitoring and store-and-forward services in reimbursement legislation.

    In 2016, Connecticut and Missouri—two states that made some of the year's most comprehensive telehealth policy changes—expanded store-and-forward reimbursement. Washington also expanded store-and-forward reimbursement as of January 2017.

    Graph 4

    5. States are expanding the types of providers that can practice and be reimbursed for telehealth services

    The most common new policy in 2016 was to expand the list of eligible providers. This meant states authorized more types of providers to practice telehealth, expanded reimbursement to more types of providers for telehealth services, or both.

    Across the 11 states that expanded provider eligibility in 2016, 28 types of providers were included in at least one state’s eligibility expansion legislation. Providers included in the changes ranged from dentists and optometrists to physical therapists and social workers.

    Graph 5

    In spite of differences between states, there are universal trends. Chief among them is that a sustainable telehealth strategy is within reach.


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