Bill Overview
Title: Greater Access to Telehealth Act
Description: This bill modifies the extension of certain Medicare telehealth flexibilities after the end of the COVID-19 public health emergency. Specifically, the bill provides that certain flexibilities continue to apply until December 31, 2026, if the emergency period ends before that date. The bill allows beneficiaries to continue to receive telehealth services at any site, regardless of type or location (e.g., the beneficiary's home); occupational therapists, physical therapists, speech-language pathologists, and audiologists to continue to furnish telehealth services; federally qualified health centers and rural health clinics to continue to serve as the distant site (i.e., the location of the health care practitioner); evaluation and management and behavioral health services to continue to be provided via audio-only technology; and hospice physicians and nurse practitioners to continue to complete certain requirements relating to patient recertifications via telehealth. The bill also delays implementation of certain in-person evaluation requirements for mental health telehealth services until January 1, 2027, or the first day after the end of the emergency period, whichever is later.
Sponsors: Rep. Schweikert, David [R-AZ-6]
Target Audience
Population: People worldwide who use telehealth services similar to those covered by Medicare.
Estimated Size: 61000000
- The bill extends telehealth services, implying those who use Medicare and require such services will benefit.
- The global population involved consists of people globally who use similar telehealth services and look to the U.S. as a precedent.
- As telehealth can cover various fields (physical, mental, and other health issues), it involves a wide range of healthcare recipients.
Reasoning
- The target demographic includes primarily Medicare recipients who used telehealth during COVID-19 or will potentially use it as part of ongoing care, meaning mostly older adults and those with disabilities.
- The policy is designed to keep telehealth options more flexible post-pandemic, which should maintain or improve accessibility for people with mobility challenges or living in rural areas.
- Budget constraints mean careful prioritization is necessary, likely focusing on populations most in need of remote healthcare access, like those in rural areas or with limited transportation.
- Simulating both users who benefit significantly and those who might be less affected will provide a balanced perspective on individual experiences.
- Primary impacts are expected where telehealth alleviates existing access barriers to healthcare services.
Simulated Interviews
retired teacher (rural Kansas)
Age: 72 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- Telehealth has allowed me to receive therapy without the pain of long drives.
- This extension means I can continue managing my arthritis comfortably.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
consultant (suburban Ohio)
Age: 65 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- Tele-audiology services save me time and money by avoiding constant trips to the specialist.
- The continuity post-COVID is reassuring.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
software developer (Los Angeles, California)
Age: 58 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 8/20
Statement of Opinion:
- Having consistent access to my therapist over the phone has been crucial for my anxiety management.
- Losing this flexibility would increase stress.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
entrepreneur (New York City, New York)
Age: 48 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 15/20
Statement of Opinion:
- I like having telehealth as an option, but it's not pivotal to my healthcare plans.
- This extension doesn't change much for me, but it's nice to know it's there.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
retired cafeteria worker (rural Alabama)
Age: 77 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- Without telehealth, it'd be next to impossible to get regular check-ups given where I live.
- Extending this makes healthcare accessible and less of a concern.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
retired farmer (rural Montana)
Age: 85 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- I see my doctor in person mostly, so this policy won't affect me that much.
- I think it's good for those who need it more than I do.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
freelance artist (San Francisco, California)
Age: 33 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 7/20
Statement of Opinion:
- Telehealth has been a game-changer for my speech therapy.
- This policy helps me continue my sessions without missing out due to scheduling issues.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
retired nurse (urban Illinois)
Age: 62 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- I like having the same quality care without needing to travel, especially in bad weather.
- Keeping telehealth as an option is very comforting.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 4 |
retired engineer (Phoenix, Arizona)
Age: 69 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- Telehealth has enabled consistent monitoring of my chronic condition, which is invaluable.
- Continuing that option is crucial for my long-term health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 6 | 3 |
non-profit director (Washington D.C.)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- Having continual access to my therapist on my schedule has been fundamental for balancing my busy work life.
- It's crucial for my ongoing mental health maintenance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 2 |
Cost Estimates
Year 1: $1500000000 (Low: $1200000000, High: $1800000000)
Year 2: $1525000000 (Low: $1220000000, High: $1830000000)
Year 3: $1550000000 (Low: $1240000000, High: $1860000000)
Year 5: $1600000000 (Low: $1280000000, High: $1920000000)
Year 10: $1700000000 (Low: $1360000000, High: $2040000000)
Year 100: $2500000000 (Low: $2000000000, High: $3000000000)
Key Considerations
- The bill primarily affects Medicare, impacting a large elderly and disabled population in the U.S.
- The scope of telehealth services is significantly expanded, influencing numerous healthcare providers.
- There is a delay in certain in-person evaluation requirements, potentially extending costs and savings.