Guest Editorial Week of 11/30/2020

Ohio has a chance to lead by example on telehealth

When the DeWine Administration postponed elective medical procedures in March to flatten the curve in coronavirus cases, many patients across Ohio resorted to an unfamiliar way of receiving medical care: telehealth.
Cincinnati’s St. Elizabeth Healthcare rose from 20 video visits in February of this year to 5,300 video visits on one day in March. The Cleveland Clinic saw an average of 5,000 visits per month before the pandemic skyrocket to 200,000 visits in April. Nationwide Children’s Hospital in Columbus has had more than 45,000 telehealth visits since March.
Experts now predict that 20 percent of medical visits will be delivered through telehealth once the pandemic subsides – and with good reason. A recent national survey shows that after months of becoming familiar with telehealth visits, remote medical care has received “one of the highest patient satisfaction scores for a healthcare services study J.D. Power has ever done.”
Telehealth makes health care safer and more convenient for patients and care providers. Virtual visits can happen in real-time through video chats, text, or by telephone, with no driving required. Store-and-forward services make it easy to share health data with doctors, potentially avoiding an unnecessary office visit. Remote patient monitoring can be especially valuable for patients with chronic conditions or patients who do not live near their doctor, and it allows care providers to identify medical issues quickly while keeping more patients out of the hospital.
Medical experts have touted the benefits of telehealth for years, but outdated restrictions prevented patients from using it. The pandemic changed that, with many states, including Ohio, relaxing their ill-advised regulations. Now that tens of thousands of Ohioans have experienced telehealth’s value first-hand, the General Assembly should expand access to telehealth and make Ohio a shining example of telehealth policy for other states to follow.
The Ohio House of Representatives has passed its telehealth bill already and the Senate now has an opportunity to enact telehealth policies that would make Ohio a policy leader. Unlike some other states, the House bill wisely does not require the same level of insurance reimbursement for telehealth and in-person visits. That means that care providers can compete on price and pass the cost savings of telehealth on to patients. The House bill also does not artificially limit how care providers deliver telehealth, which medical specialists may use it, or limit patients to video visits – so patients without broadband access may still use their telephones to “see” their doctors.
The Senate should leave those House provisions in place and make some minor, but important improvements. The current House bill treats telehealth cost-sharing the same as it does in-person visits, with the exception of preventative care visits initiated by a patients’ existing doctor. This is a mistake. Instead, insurers and care providers should negotiate all cost-sharing arrangements in order to discourage overusing low-value medical services. Consistent cost-sharing rules will also encourage the healthy competition that health care needs.
The current bill does not limit telehealth to particular specialists or services, but Ohio’s medical board retains significant discretion on this point. As doctors, patients, and policymakers continue to discover which medical services are best suited for telehealth, Ohio’s medical board should adopt language that holds care providers to the same professional standards for telehealth as required for in-person care.
The Ohio House has passed important, needed legislation that will benefit the state’s patients and health care systems. The Senate should do likewise and avoid adding provisions that might hobble telehealth’s value and effectiveness. Ohio is on the verge of taking the national lead in smart telehealth policy and making medical care safer and more convenient for all. Now is the time.

James B. Woodward, Ph.D., is an economic research analyst for the Economic Research Center at The Buckeye Institute in Columbus, Ohio and the author of Access to Health Care Made Easier: Promoting Best Practices in Ohio’s Telehealth Policy.