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COVID-19 necessitated widespread loosening of state and federal restrictions on and rapid expansion of telehealth. Now, as policy makers consider telehealth in the post-pandemic period, they must make decisions about payment parity—whether to continue reimbursing clinicians equivalent amounts for in-person and telehealth visits.
Some argue that telehealth requires less clinical effort and fewer overhead costs than in-person care, undercutting the case for payment parity. Other concerns include telehealth’s lower effectiveness compared to in-person care, the potential for overuse and fraud, and increased health care spending. Those who support payment parity believe it would help clinicians adopt and maintain telehealth as a way to support health care access and patient experience. Arguments on both sides would be strengthened by more high-quality studies.
Because many tensions about payment parity are rooted in volume-based reimbursement, another way to help resolve the debate is to test telehealth within dedicated value-based payment models.
For instance, one concern about continued telehealth payment parity is that it could spur use that adds to, rather than substitutes for, in-person care, thereby increasing use and spending without clear clinical benefits. These risks may be enough for some payers to shift away from parity for certain telehealth modalities. Medicare has proposed that it will limit audio-only telehealth to mental health services in specific situations after the public health emergency.