Arizona's Telehealth Reform Could Supercharge American Healthcare
For Claudia, making an all-day drive to get needed medical treatment was simply a fact of life. Twice a week, Claudia drove three hours each way, plus frequent stops, to take her disabled daughter from their Yuma, Arizona, home to Phoenix to get the regular care she needed. But now, she’s able to see the doctor on a computer or a smartphone for most of the appointments, and the mother and daughter only need to make the trip to Phoenix once a month.
Why the change? During COVID-19, rules regarding telehealth — technology that enables people to get help from their healthcare providers directly on their smartphones, computers, and landline phones — were relaxed so that in-person appointments would be limited for safety’s sake during the pandemic. In-person appointments are frequently not necessary to deliver the type of care needed, and telehealth can help provide that care to a patient from the convenience and comfort of their own home. And that’s been a game-changer for many Americans like Claudia and her daughter.
The COVID-19 crisis has demonstrated like never before the benefits of telehealth — and has shown us just how irrational the past rules limiting telehealth were. But it shouldn’t take a pandemic to transform healthcare for the better, and expanded telehealth options shouldn’t go away when COVID-19’s threat subsides. We must continue to work toward a healthcare system that meets healthcare needs flexibly, by harnessing the potential of 21st-century information and expertise. A bill working its way through the Arizona legislature could take a giant leap forward in doing just that — and set a powerful precedent that ought to be emulated in states across the country.
That bill (Arizona House Bill 2454) is a first-in-the-nation effort backed by the Goldwater Institute that would allow registered healthcare providers who are in good standing in other states to provide services to Arizonans via telehealth. So if you need, say, behavioral health services, speech therapy, or care for a chronic condition, you can receive that care via telehealth more easily. While this proposal will add convenience for patients, it will do so much more — transforming the healthcare delivery landscape, allowing for the reimagining of how care is delivered.
Federal healthcare programs plus 41 states took steps to make telehealth more readily available during the pandemic. These modified requirements included allowing out-of-state physicians to provide telehealth services, eliminating the requirement for preexisting provider-patient relationships, and allowing for both audio and/or video telehealth options, among other reforms. Now, this Arizona reform proposal will build upon this demonstrated success, supercharging healthcare access by using the power of technology and medical expertise in ways that have not yet been fully realized or, in some cases, yet unimagined.
And the opportunities for transformation are all around us: Arizona’s reform would revolutionize:
- Rural care. Most states have exceptional care available in larger urban areas, with some drawing patients from around the world. But these same states almost always face shortages of providers in rural areas, making it difficult for their residents to access needed care without travel and the associated expenses. Too often, patients with limited access either delay care or forgo it altogether, causing further deterioration in one’s health. Arizona’s telehealth reform will make it easier for those patients — like Claudia’s daughter — to get needed care more often and in a timely manner.
- Hospitals. Most hospitals lack the ability to hire a multitude of specialists, but HB 2454 provides an important pathway for medical facilities to provide needed expertise and assistance without having to have it in-house. For example, should a patient in a rural area suffer a serious stroke, a community hospital may be able to, in real time, have the patient’s vital statistics shared and monitored with a leading specialist at another facility across the country, obtaining medical guidance that had been previously unavailable. In this way, hospitals can re-tool their services and offerings in a way that better allows financial flexibility and can better meet the needs of their patients.
- Insurer policies. While telehealth reimbursement policies have been dramatically expanded during COVID-19, many of the policies that limited coverage of these services are on track to revert to the pre-COVID status quo, absent federal and state policy and legislative reforms. Because the policies that govern the federal healthcare programs are often followed by private insurance policies, HB 2454 offers an opportunity to untether these coverage and payment decisions, encouraging new payment models that work better for families like Claudia’s.
In the past, lawmakers in many states have imposed one-size-fits-all rules that prevent medical innovation and restrict the availability of healthcare services to patients in need — and those rules left Americans like Claudia and her daughter in a bind. But Arizona’s reform proposal is a rejection of the business-as-usual approach to healthcare delivery and allows providers to put patients first.
Telehealth holds enormous potential for healthcare access, and while there are no magic bullets to healthcare reform, HB 2454 can help Arizona realize the potential of innovative, patient-centric medical care through the use of already-available technology and communication. This is exactly the kind of bold thinking and action that lawmakers across the country have the authority — and obligation — to embrace and pursue.
Naomi Lopez is the Director of Healthcare Policy at the Goldwater Institute.