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Regulations are changing that will affect the future of telehealth


Everything during the pandemic was inconvenient, except the rise of telehealth. Talking to doctors from home was astonishingly convenient. But nothing that good can last. Regulations are changing. NPR's consumer health correspondent Yuki Noguchi is following this one. Good morning, Yuki.


KING: OK. So telehealth came to be, like, a regular part of life during the pandemic, and it happened really quickly. But now things are shifting in another direction. What's going on?

NOGUCHI: Yeah. So the reason we saw this sudden boom in telehealth was because state and federal governments temporarily did away with their normal restrictions at the beginning of the pandemic. And that's what allowed doctors to do things like FaceTime us or write prescriptions, you know, even if we'd moved out of state, which would not have been permitted before the pandemic. But those waivers are temporary. Now those exemptions have either expired or are expiring, meaning they'll default back to the pre-pandemic rules - that is, of course, unless the laws change.

KING: Are the laws going to change, you think?

NOGUCHI: Well, right now, you're seeing tons of legislative activity. There are literally a thousand telehealth-related bills pending before state and federal lawmakers right now.

KING: Wow.

NOGUCHI: And so far, 33 states have passed laws extending at least some of these waivers that make telehealth more flexible. Arizona adopted the most radical changes. It now allows out-of-state doctors to treat patients, including writing prescriptions. So basically, what you have today is a patchwork of rules across the country. Whether you can still get remote care really depends on the state you live in.

KING: OK, much like a lot of things in this country. What about health insurance? Will it still cover telehealth?

NOGUCHI: Yeah, it's - there, too, it's a mixed bag. Medicare administrators recently said they will continue to cover telehealth visits for behavioral and mental health through 2023 and for health centers that serve poor and rural communities. But they haven't said whether they'll continue to cover physical health visits after the national health emergency's lifted. Now, if you have a private insurance plan, like what you get through an employer, there's a good chance you'll see some changes there as well because those private insurers are cutting back on various forms of coverage. For example, if you were able to consult a doctor just over the telephone last year because you didn't have a good internet connection, well, that might not be covered anymore. So the bottom line for consumers is know what's allowed in your state or ask your insurer what it still covers.

KING: I'm sure you can tell by my voice that I truly adore telehealth, but I do wonder, medically, is there data showing that it's effective?

NOGUCHI: Well, you know, there's still data coming out on that, you know, that depends on the specialty and what kind of care, of course. Broadly, what we know is that the real benefit of telehealth, as you've noted, is that it lowers barriers to care, right? Think of people in rural areas or in communities that don't have a psychiatrist or dermatologist. They could dial into that kind of care. On the other hand, telehealth isn't as effective for treatment of certain conditions. Like doctors say, you know, things like skin color and tremors don't really come through on a small screen, nor does the smell of alcohol on someone's breath. So you want to balance these benefits of convenience and access against some of these other concerns about the limitations of a virtual doctor visit.

KING: So the data from health professionals is to be determined. What do actual patients say when you ask them whether they like it and find it effective?

NOGUCHI: Well, you know, in some cases, they say it's more effective. It's convenient, so people can keep their appointments more regularly. One patient, Mack Jones of Fayetteville, N.C., pointed to a benefit I had not thought about. When he uses FaceTime, there's obviously no nurse weighing him or taking his blood pressure because, you know, he's doing this from home. So he has to do that all himself, which he says has made him take more responsibility for his health.

MACK JONES: It makes me weigh myself. It forces me to take my blood pressure to know what my numbers are. I'm actively, you know, monitoring myself, making sure that I'm drinking a certain amount of water. It made me an active participant.

NOGUCHI: And, you know, Jones discovered that just by doing that, you know, by being more involved in his own health, he was able to lose 50 unwanted pounds, you know, which actually bucks a trend during this pandemic.

KING: Yeah (laughter).

NOGUCHI: So while he won't mind seeing his doctor in person - he says he really likes going to the doctor - like many people, he also doesn't want to see telehealth go away entirely. And he, like a lot of other people, see a future where there will be a hybrid of both in-person and remote care.

KING: NPR health correspondent Yuki Noguchi. Thanks for this.

NOGUCHI: Thank you, Noel. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Noel King is a host of Morning Edition and Up First.
Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.