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Can Telehealth Solve the Access Issue?

Friday, April 15th, 2016

Access to appropriate and timely care is an all-too-common issue plaguing rural and urban communities across America.

TH PDF graphicSome access issues are a result of primary and specialty provider shortages. Other access issues can be attributed to the design of a health plan’s network.

Telehealth (aka Telemedicine), a tool increasingly used by hospitals and physicians, may be the key to solving both of the aforementioned access issues.

Growth of narrow networks has sparked increased regulatory focus on a health plan’s ability to provide an adequate network that meets member needs. Researchers at Georgetown University, in partnership with the Urban Institute and funded by the Robert Wood Johnson Foundation, recently released a study that examined the opportunities and challenges facing telemedicine as a tool for insurers to use in demonstrating network adequacy.

The Georgetown study noted there’s a patchwork of state regulations both expanding and limiting the use of telehealth, depending on the state. While growing in popularity, many physicians and regulators remain concerned about the quality of care delivered via telehealth. Additionally, it was reported that insurers – to the degree it was utilized – often employed telehealth services only for certain specialty groups as a consultative service or follow-up to already-delivered care.

Regulatory respondents cited in the study predicted that “telemedicine providers have the potential to help support an adequate local network, particularly for specialty services… that can effectively deliver care remotely as a way to address widespread provider shortages.” The study also noted none of the states studied had issued or published guidance to health plans indicating whether or how telehealth would be judged when insurers’ access plans were reviewed.

Before regulators accept a health plan’s use of telehealth services as a demonstration of network access, they must first ensure that, like an in-person office visit, the telehealth service delivers an acceptable quality standard of care. This care must be delivered in an appropriate setting and in a manner that protects the patient from harm.

In response to requests from telemedicine leaders, URAC created a robust Telehealth accreditation program to meet demand for an objective, independent validation of the highest standards of telemedicine quality, safety, compliance, and patient protection.

Given the rigor and high level of performance required of applicants, telehealth service providers who achieve URAC accreditation will demonstrate their commitment to industry-leading best practices. Regulators can be confident that health plans utilizing URAC accredited telehealth services have a patient-focused framework for access to quality health care services.

Many states already use URAC accreditation to augment oversight of health plan operations. URAC’s Telehealth accreditation can be a source of additional leverage to assure that patients have access to the quality and timely care they need.

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For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care.
For more information about URAC, contact us.

Interested in accreditation?
Contact businessdevelopment@urac.org

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