A report released this week examines telehealth policies on a state-by-state basis in an attempt to highlight what authors see as best practices in terms of patient access and ease of providing care.  

The study is a joint project from libertarian think tank Reason Foundation; the Cicero Institute, which partners to design "market-driven policy systems"; and the Pioneer Institute for Public Policy Research, whose mission focuses on the application of free markets.  

Their criteria of best practices focuses on supporting modality-neutral options, supporting the ability of all providers to use telehealth and allowing for interstate licensure.  

On the other hand, they advise states not to require in-person visits before using telehealth or mandating payment parity. The latter is a particularly thorny issue where advocates, providers and policymakers are concerned.  

"While they cannot and should not replace all in-person medical appointments, virtual visits can save patients time and help them avoid germ-filled waiting rooms. Providers can also cut down on their risk of exposure and take some pressure off overburdened systems as they can see patients from an office or home," wrote the report's authors.  

WHY IT MATTERS  

According to the report, nearly every state does not require in-person visits prior to telehealth: Only Alabama, Tennessee and West Virginia do so in some capacity.  

Meanwhile, 22 states allow any provider to use telehealth, including Alaska, Hawaii, Illinois and Texas. California and New York, however, are two of the states with codes limiting their definitions of the kinds of providers who can use virtual care.  

More than half of states are "modality-neutral," defined as allowing synchronous and asynchronous forms of care.  

By contrast, nearly every state has barriers in place to telehealth across state lines. Only Florida, Arizona and Indiana have what the report defines as a "clear, straightforward, predictable registration or licensing process for all out-of-state healthcare providers."  

Steps exist to address those hurdles, however: Many states have established compacts to try and ease the process for cross-border care. Half the country is a member of both the Nurse Licensure Compact and the Interstate Medical Licensure Compact, with 16 more states claiming membership in one.  

"As more Americans are mobile, being able to stay in touch with providers who know the patient's history and have their trust is imperative to better health outcomes, and far better than the status quo that forces patients to start over with a brand-new provider," argued the report's authors.  

THE LARGER TREND  

Although telehealth continues to be a rare example of policy supported on both sides of the political aisle, the devil is in the details – particularly around insurance coverage and interstate licensing.   

As the report shows, several states have passed their own policies in lieu of long-term federal action. However, many pursued changes through administrative action, which may not be permanent.  

ON THE RECORD  

"States need to act now to ensure the physical and economic needs of their state are met with a more quality- and future-oriented health system," read the report.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.