Could Too Much Telehealth Drive Up Medicare Costs? (Guest: Josh Gordon, Ph.D.)

Telehealth soared in popularity soon after Medicare started covering telehealth claims during the pandemic. There is a five-month time limit on reimbursing claims after the pandemic emergency declaration ends, which is now expected after the mid-term election. Before making reimbursements permanent, Josh Gordon, Ph.D., Director of the Health Policy Committee for a Responsible Federal Budget, recommends putting guard rails in place to prevent waste, fraud, and abuse of telehealth claims, especially in a fee-for-service model such as Medicare. Congress will also have to reconsider pay parity, since telehealth should cost less than a physical visit.

To most, telehealth is relatively a new phenomenon. Before the pandemic, Medicare barely covered it. First, Medicare patients had to be living in an underserved rural area. If they did receive a telehealth visit, it had to be done at an approved health care facility. When the pandemic hit, and states instituted lock downs, telehealth was a saving grace because it was the only way many patients could get health care. Telehealth visits are fully covered by Medicare, but only during a public health emergency. Gordan talks about how telehealth could lead to higher health care utilization which would drive up Medicare costs.  He also addresses telehealth innovation and whether “guardrails” could slow this down. The Committee for a Responsible Federal Budget released this paper on the topic on April 21, 2022.

https://www.crfb.org/papers/fiscal-considerations-future-telehealth