Accessing health care has been a longstanding challenge for the 1 in 2 DC children who rely on Medicaid. The pandemic made it even harder – but it also created an opportunity to expand access through telemedicine.
Children’s Law Center wanted to learn more about how telemedicine was working and what lessons we could learn for post-pandemic health care. To inform our thinking, we gathered some of the brightest minds for a community conversation.
We spoke with Melissa Byrd, DC’s Medicaid Director, Karen Dale, Market President of AmeriHealth Caritas DC, and Sharra E. Greer, Children’s Law Center’s Policy Director, to learn more about how the District pivoted toward telehealth and what lessons we have learned.
There is no question that telemedicine has been a critical health tool during the pandemic. As Melissa shared during the conversation, “We saw about 13,000 [telehealth] claims before the pandemic, but since March 2020, we've had over 232,000 claims. We went from having less than 1% of beneficiaries at the beginning of the year using telemedicine to almost 18% since the pandemic.”
The panel identified a few reasons why DC was able to move so quickly. First, the strong, established partnerships among advocates like Children’s Law Center, the government, providers and insurers meant problems were quickly identified and each partner could play their role in solving it.
The federal government’s loosening of HIPPA restrictions also allowed telemedicine to be available more widely.
One eye opening discovery was how many people used telehealth for their behavioral health appointments. Of the 232,000 claims, 71% were for behavioral health care.
Karen explained “[P]eople who previously didn't have a diagnosis. . . are certainly moving into having an adjustment disorder that's turning into a bit more anxiety, that's turning into major depression." She also acknowledged that telehealth removes some of the stigma that comes from visiting a therapist’s office.
Sharra pointed to the COVID-19 Child and Adolescent Mental Health Resource Guide which Children’s Law Center complied to give families information about which mental health providers were available through telemedicine.
There are some other benefits to telehealth. In the past, doctors’ offices faced high no-show rates – often due to the barriers families faced getting to appointments. With more telehealth use, Karen shared that those rates have dropped to nearly zero.
But the panel also made clear that telehealth cannot completely replace in-person visits – and it is not available to everyone. Many families do not have the right technology or internet connection. And there are times when in-person visits are critical. Karen raised concerns that reliance on telemedicine would affect immunization rates. And the panel acknowledge that telehealth cannot continue at this scale unless the federal government makes the current regulatory changes permanent.
We have yet to see what telehealth will mean for health outcomes over time. But the group agreed that the need for greater telehealth use is clear – even once the pandemic is over.