A great majority of us will be happy to shed most practices associated with the pandemic era as soon as logistically possible. But within the broader healthcare realm, there are more than a few COVID-prompted changes worth keeping, whether the ongoing push to eliminate health disparities, the long-gestating effort to lower drug prices or the expansion of virtual care.
A new report from the Pew Charitable Trusts calls attention to another pandemic adaptation worth keeping. Recent federal tweaks to telehealth regulations are subject to change — so it will be left to the states to greenlight expanded access to telehealth, especially in the treatment of individuals caught in the throes of addiction.
Sheri Doyle, a manager of the substance use prevention and treatment initiative at Pew, believes rising opioid abuse and drug overdose rates make telehealth expansion even more essential. In November, the Centers for Disease Control and Prevention released data showing that overdose deaths in the U.S. reached record levels between April 2020 and April 2021. That represents a stunning 28.5% surge.
“Life-saving medication to treat opioid use disorder is available, but it’s not easily accessible,” Doyle said. “Telehealth lowers the barriers to accessing treatment for a lot of people.”
Prior to COVID-19, in order to start treatment with buprenorphine — a medication used to treat opioid use disorder — patients would have to physically enter a clinician’s office to receive a prescription. Now, due to the pandemic-era changes, patients aren’t required to make that in-person visit.
Telehealth has also offered a pathway to treatment for people who struggle with addiction while experiencing other barriers to effective healthcare. That includes members of minority groups, people living in rural or remote areas, people newly released from jail or prison and people experiencing homelessness.
“States need to take more action,” Doyle said flatly. “States have a lot of flexibility and it’s important that they examine their policies to make sure patients can continue to benefit from telehealth.”
The Pew brief outlines several policy recommendations for states. The group highlights the importance of ensuring that public and private insurers reimburse treatment providers and that telehealth-provided services are reimbursed at the same rates as in-person treatment.
Doyle also suggested allowing patients to access services wherever they’re located, including their homes. Prior to the pandemic, some states required patients to go to clinical settings in order to access telehealth.
Of course, barriers remain even in the virtual care world. Recent research has shown that, despite a surge in telehealth use during the pandemic, patient satisfaction has declined as some users struggle with internet access, tech issues and service costs.
Ultimately, it may come down to the willingness of telehealth providers to build more flexibility into their policies. Doyle noted that telephones should be allowed in telehealth sessions, given that around 14.5 million people lack broadband access (that number may be even higher).
“The programs that work well offer a lot of options and flexibility, same-day appointments and follow-up care,” Doyle said. “Patients need those options. Individuals who started addiction treatment during COVID-19 could have difficulty remaining in treatment or counseling if their telehealth access goes away. There’s no reason why this should change post-pandemic.”