Establishing A Value-Based ‘New Normal’ For Telehealth

The coronavirus (COVID-19) pandemic has necessitated an unprecedented level of innovation and redesign. One prominent manifestation is the catalyst of telehealth from fringe to mainstream. The impact of telehealth on quality and cost of care remains largely unknown. As policies facilitating this transition are set to expire with the public health emergency declaration, important decisions regarding its future role are in a state of flux. Determination of the post-pandemic role of telehealth will be complex and consequential, and should be grounded in a value-based approach. This post capitalizes on the natural experiment afforded by the COVID-19 pandemic and proposes a value-driven telehealth policy and research agenda.

Catalysts For Widespread Adoption Of Telehealth

Telehealth adoption prior to the COVID-19 pandemic was slowly increasing but remained low. This was likely attributable to obstacles including the lack of a consistent payment strategy, unclear relative advantage and implementation scope, education and infrastructure investment requirements, lack of experiential foundation, and concerns surrounding fraud and abuse. COVID-19 demanded emergent recalibration of risk-benefit considerations and consequently rendered previously perceived barriers as surmountable, propelling telehealth from a marginal service into a widespread strategy. Telehealth was prominently included in key federal and state policy provisions (Exhibit 1) facilitating its hasty adoption. After initial unprecedented adoption rates, telehealth visits have now plateaued at a level of utilization much higher than preceding the pandemic.

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