Skip to Content

As virtual doctor’s visits rise in popularity, major health insurers change the rules

On October 27, 2020, MarketWatch reported that health insurers are rolling back coverage for telehealth services even though demand is way up due to COVID-19. Here's a look at how insurers are un-covering much needed care.

Up until COVID-19 hit, utilization of virtual care was extremely low. Most people had never tried telehealth; some weren’t even aware that they could connect with doctors and nurses from their phones or computers. On the provider side, tight regulations and lack of equal reimbursement rates kept adoption low. But telehealth has exploded over the course of the pandemic, with key pieces of legislation such as the CARES Act, as well actions by CMS, removing barriers to widespread use. Insurers started paying providers at rates equivalent to in-office visits. As a result of all these collective actions, virtual care flourished and allowed patients to get the medical attention they needed from the safety of their homes. However, right as a third wave of COVID-19 started to hit in some areas of the country in October, several major insurers abruptly stopped reimbursing providers for virtual visits at the same rates as in-person visits. Payors have also rolled back coverage of telehealth for non-COVID-19 issues. As important a role as telehealth has played in bridging gaps in care and creating access during the pandemic—which continues to rage on—it appears that financing it is too expensive for payors to continue, despite public earnings statements reflecting continued record profits.

Original Article:

Health insurers are starting to roll back coverage for telehealth – even though demand is way up due to COVID-19.
MarketWatch | Jennifer A. Mallow, Steve Davis

Show me more proof!

Sign up to receive our regular roundup of the latest evidence of payors’ bad behavior across the healthcare ecosystem.