In October of 2020, we covered a story about health insurers rolling back coverage for telehealth services, right as demand was skyrocketing due to COVID-19. During the pandemic, virtual visits have been celebrated as a convenient, safe way for many patients to continue getting the care they need. And most payors did the right thing by covering these visits, at least initially. This fall, however, several major insurers decided to scale back on what they will cover via telehealth, despite the pandemic continuing and despite an alarming drop in utilization of preventative care services.
So what was behind this seemingly strange reversal? Some have argued that it comes down to dollars—with so many members using telehealth for so many things, virtual care posed a significant threat to the record profits insurers raked in last year. Although UnitedHealthcare just made a big splash with a new primary care program that offers routine telehealth visits with little or no co-pay, upon closer scrutiny the program is quite limited—it’s only for employers and is available in a limited number of states. To us it seems as though payors are picking and choosing what virtual care to cover based on their interests, not those of their patients.
Fortunately, on New Year’s Day Massachusetts Governor Charlie Baker signed a law that requires insurance companies in his state to cover telehealth visits the same way they cover in-person care, permanently. The law also offers a short-term solution to ensure telehealth is adequately and fairly paid for, with the expectation that telehealth will continue to be an important part of healthcare delivery post-pandemic. While we see this outcome as a victory, we wonder about the path to getting there. Will insurers continue to dictate which types of telehealth they cover, as United has done, or will the government step in to ensure continued access? In other words, will we have to continue to essentially force insurers to do what they were designed to do, cover the care of those in need?
