Medicaid managed care can play a significant role in promoting the use of audio-only options. Empowering Managed Care Organizations to Promote Audio-Only Options and Supports.Many of these states offer parity for both video and audio-only telehealth services. As many as 27 states have already extended payment parity between telehealth and in-person care for Medicaid providers beyond the Public Health Emergency. The simplest way for states to continue to support access to audio-only visits is to pay providers directly for these visits. Extending Payment Parity for Telehealth Visits. Medicaid agencies have an opportunity to support phone-based telemedicine in primary care beyond the pandemic, and many are already doing so. How States Can Support Audio-Only Telehealth Video visits may require potential up-front infrastructure costs, as well as recurring maintenance and staff training to use the software effectively, none of which are necessary for audio-only visits. Under-resourced safety net primary care providers serving Medicaid enrollees may find it easier and less cost-prohibitive to offer audio-only visits rather than video visits. The potential challenges and benefits apply to Medicaid providers as well. At the same time, telehealth could help people overcome transportation barriers, or prevent loss of income from having to travel to a provider’s office during business hours. Results indicated that during the COVID-19 pandemic, the highest rates of telehealth visits overall were among Medicaid enrollees, Black, and low-income individuals, while the use of video telehealth services were far lower for elderly, Black, Latino, and Asian individuals than white individuals and people earning over $100,000. Department of Health and Human Services confirmed many of these findings. A recent national survey on trends in telehealth released by the U.S. Medicaid enrollees are also often affected by the “digital divide” - a lack of access to reliable internet services due to income, race and ethnic disparities, and/or rural geography. However, Medicaid enrollees may be less likely to complete video visits, which can be especially difficult for people who are elderly, live in rural areas, or are non-native English speakers. Most Medicaid enrollees can engage in audio-only visits - according to the Pew Research Center, 97 percent of Americans own a cell phone, and 85 percent own a smartphone. People enrolled in Medicaid are among the most likely to benefit from the continuation of audio-only visits. The Toothpaste is Out of the Tubeīecause we cannot “put the toothpaste back in the tube” (or “the genie back in the bottle,” metaphors abound), many providers, payers, and consumers are considering how to continue using audio-only visits. While not all medical services can be delivered using video (a blood draw) or phone (teledermatology), some services, like telematernity and behavioral health visits, have great potential to meet health needs and improve health equity. Many providers and patients found low-tech phone visits to be high value - resulting in high patient satisfaction and decreased “no show” rates. While many virtual visits used video, audio-only phone visits were also commonly used. As part of the Public Health Emergency, the Centers for Medicare & Medicaid Services allowed broad flexibility to use telehealth, spurring unprecedented use of telehealth. The COVID-19 pandemic forced many providers to dive in headfirst when telehealth became the only way patients could access health services. health care system, a debate is underway about whether medical care and services can be adequately delivered through telehealth.
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