Telehealth and Disability: What You Need to Know

July 15, 2020

It was, and still is, a frequent call from clients during the COVID-19 pandemic: “I can’t see my doctor because their office is closed due to the coronavirus.” However, when we suggested telehealth, our clients’ ears often perked up. In fact, many of our clients were using telehealth visits already, both for physical and mental health treatment.

In 2019, only about 11% of Americans used telehealth—professional healthcare provided remotely through video and internet technology. Fast forward to mid-2020, and telehealth usage has blossomed. Since the arrival of COVID-19 on American shores, telehealth has come of age (not surprisingly). Forty-six percent of U.S. consumers are now routinely using telehealth. Previous barriers to the use of telehealth— including consumer awareness and physician and patient resistance—have faded into the background.

Telehealth offers benefits for healthcare providers and consumers alike. Telehealth helps protect frontline healthcare workers by reducing the chances for exposure to the COVID virus. Typically, a telehealth consultation is shorter than a traditional in-patient appointment, which means that physicians and other medical professionals can see more patients in a day. There is time saving for patients, too, with no travel time and no time wasted idling in waiting rooms. This means patients can take less time away from work or home. Costs also decline. The average in-person doctor’s visit costs $149, while the average telehealth visit only costs about $79.

Another valuable patient benefit of telehealth is the reduced chance of exposure to the COVID-19 virus and other communicable diseases in waiting rooms and exam rooms. This key benefit of improved health outcomes is particularly crucial for those who have disabilities and have underlying medical issues which make them more vulnerable to illness and even death due to the coronavirus. “Without question, vulnerable populations see the benefits of telemedicine services,” says Karen Rheuban, MD, director of the University of Virginia’s Karen S. Rheuban Center for Telehealth in Charlottesville, Virginia, in an article in MedPage Today. “We can monitor vital signs, blood pressure, heart failure, and many clinical conditions that would otherwise require in-person visits; therefore we can lower the cost of care and improve outcomes.”

Most insurance companies will pay for telehealth visits. Medicare recently expanded its coverage of telehealth services. “During this emergency, Medicare will pay for telehealth services at the same rates as in-person services, giving doctors and other medical professionals the opportunity to reserve their offices to treat those who truly require in-person care,” Seema Verma, Administrator of the Centers for Medicare and Medicaid Services, reported in a press release.

Despite the benefits, there are some hurdles in the path of wider acceptance and use of telehealth. Some patients perceive telehealth as less effective than in-person care, but that perception is changing. A study from last year shows that satisfaction with telethealth has improved with 62% of Americans saying that the quality of care is the same as an in-person visit. There is also uneven access to the necessary technology. Many people—especially those who are lower on the socio-economic scale—do not have computers or internet access. This is a need that must be addressed.

Another headwind slowing the expansion of telehealth is the issue of reimbursement rates for doctors. Physicians have more incentives to conduct in-person treatments because they pay better. Federal regulators have allowed Medicare and Medicaid to pay telehealth costs for office, hospital, and other visits. Some major health insurers have followed suit, but not all of them. Among the states there is a patchwork of telehealth coverage and reimbursement laws. In Illinois, Governor J.B. Pritzker issued an executive order in March requiring insurers to reimburse telehealth services at the same rate as in-person office visits. In late May, the Illinois House passed a bill that would have extended this order until the end of the year, but state legislators adjourned before the provision came up for a Senate vote.

At Nash Disability Law, we are in favor of any method of treatment that increases access to care for our clients so that they can receive treatment for their conditions. After all, disability cases are often won and lost based on the medical records. Those without reliable transportation, or fewer access to funds, may be able to utilize telehealth, whereas standard treatment would be much more difficult.

Hopefully, telehealth lessons learned during this unusual time will spur federal and state lawmakers to act. Most medical experts believe that even when the pandemic retreats, telehealth consultations will continue to be a widely-used method of delivering healthcare services.