Looking ahead, two policy levers that can be leveraged to better support Telehealth are alternative payment models and Federally-Qualified Health Centers (FQHCs).
Alternative payment models have increasingly been recognized by private and public payers altogether as a great way to reach the Triple Aim of access, quality and cost. Among value-based models, bundled payments seem particularly conducive to the generalization of optimal Telehealth services utilization and reimbursement, The model is supported by both CMS’s Innovation Center and the Agency for Healthcare Research and Quality (AHRQ).
FQHCs deliver an important part of both primary and specialty care in underserved areas, yet research shows they tend to under-utilize telehealth (Uscher-Pines et al, 2019). While both states and CMS have launched initiatives aimed at boosting Telehealth utilization in FQHCs, they primarily did so by addressing reimbursement issues (Uscher-Pines et al, 2019). Research, however, shows that low provider buy-in FQHCs goes beyond reimbursement issues, and has to do with challenges specific to both the patient population (e.g., elderly patients, homeless patients), and organizational factors like complexities in adjusting clinic workflow, or complex and time-consuming logistics around credentialing and licensing (Uscher-Pines et al, 2019). Comprehensive measures that reflect the complexity of the FQHC environment are thus needed.