COVID-19 has demonstrated the remarkable power of a crisis to propel healthcare transformation. With the rapid adoption of telehealth technology, there are a host of virtual options available in place of the traditional office visit for people confined in their homes.
Applying technology to bridge gaps between patients and providers is an important advancement in healthcare equity. Almost half the nation’s network of community health centers, which today serve 30 million patients, had adopted telehealth before the pandemic struck.
As mission-driven innovators, health centers reach beyond the exam room to reach patients where they are. Telehealth seemed the logical accompaniment, if not a game changer, to expand access to care.
The need is especially critical in rural America, where hospital closures have forced people to travel longer distances to see a provider. The range of telehealth services at health centers may vary, but the offerings can include behavioral health and substance abuse counseling, dentistry and vision, and routine primary care (with the caveat that some services, such as pediatric immunizations, obstetrics, and chronic care do require in person visits).
There are also obvious cost-saving incentives. Telehealth can mitigate staffing challenges by allowing a single provider to serve multiple health center sites spread across different communities. Promising telehealth pilot projects have also generated lower hospital admission rates and healthcare costs.
In Ahoskie, North Carolina, Roanoke Chowan Community Health Center (RCCHC) has been caring for patients virtually since 2006. Prior to the COVID-19 outbreak, RCCHC operated an in-home, remote patient monitoring program for patients with chronic conditions, like cardiovascular disease, diabetes, and hypertension, which slashed hospital admission and readmission rates by 75 percent. Now the health center has moved most patient appointments to online or over the phone, and they are far from alone in taking such measures.
The fear of contracting COVID-19 emerged as a daunting barrier to necessary care as many people followed stay-at-home orders. Delaying care can be catastrophic for health center patients, as they are typically older, poorer and suffer from multiple chronic problems compared to the general population. Yet health centers adeptly pivoted. At the height of the pandemic, 98 percent of health centers held virtual visits.
Federal payers like Medicare and Medicaid, with the help of congressional lawmakers, also rapidly amended billing rules to grant more flexibility and boost reimbursement rates for telemedicine.
These actions, as well as targeted funding from the Federal Communications Commission, helped soften the staggering financial blows health centers sustained due to decreased in-person visits by up to 50 percent during the pandemic, while also boosting broadband connectivity in hard to reach communities.
Public and private investments in telehealth are likely to continue beyond COVID-19, but technology is only as good as the humanitarian intentions behind it.
For community health centers, telehealth was and remains a critical tool for a mission that has spanned five decades: to heal communities in need and grant health equity to the most vulnerable among us.