POLI 330N Week 7 Assignment: Final Project – Policy Issue

Student Name

Chamberlain University

POLI-330: Political Science

Prof. Name

Date

Concern or Problem – Telehealth Policy

The COVID-19 pandemic exposed critical vulnerabilities in the U.S. healthcare system, including insufficient infrastructure, disparities in care, limited disaster preparedness, and other systemic weaknesses (Chao et al., 2021). Many patients were unable to access essential healthcare services, leaving providers, particularly nurses, struggling to deliver adequate care in settings such as home-based care, hospice, community clinics, and hospitals (Johnston et al., 2021). Telehealth emerged as a potential solution, but existing policies present significant challenges that hinder its effectiveness (Shaw et al., 2020). This policy paper evaluates telehealth policy challenges and proposes actionable recommendations for Congress members to improve access, quality, and affordability of care.

Defining the Problem, Identifying Its Importance, and Urgency

Despite the demonstrated potential of telehealth services, the U.S. has not yet established these services as permanent (Shrank et al., 2021). During the COVID-19 pandemic, telehealth usage surged to over 9 million users. For instance, the number of beneficiaries increased from 1.7 million per week to 13,000 after the initial pandemic wave (Shaw et al., 2020). Patients expressed a willingness to continue telehealth usage; however, no permanent policies exist to sustain this access.

The urgency of addressing this issue is underscored by disparities in healthcare access, particularly in rural areas where 42% of patients struggle to receive adequate care (Wegermann et al., 2021). Delays in implementing telehealth-supportive IT infrastructure exacerbate these gaps, contributing to higher mortality rates. A study in rural North Carolina revealed that limited access to care resulted in 42,985 opioid-related cases and 1,062 deaths between March and June 2020 (Hughes et al., 2021). Telehealth visits peaked in May but declined sharply thereafter, illustrating the negative consequences of inconsistent policy support.

In addition, healthcare providers face obstacles such as obtaining licenses, navigating FQHC restrictions, network limitations, lack of high-speed internet, and suboptimal video quality (Shrank et al., 2021; Johnston et al., 2021). Current policies fail to address the potential use of audio-only telehealth services, limiting accessibility and worsening patient outcomes.

Analyzing the Problem

The key challenges preventing permanent telehealth adoption include:

• Limited healthcare access in rural and underserved areas

• High healthcare and telehealth service costs

• Inadequate policies for both video and audio telehealth modalities

• Difficulties in telehealth license accreditation

• Rising overall healthcare expenses

Telehealth Access Barriers

Telehealth services, including both video and audio, can improve access and reduce overall costs. The FamTechCare intervention, which combined audio and video services, reduced costs to $6.9 per patient dyad per week compared to $48.43 for video-only services (Shaw et al., 2020).

Healthcare Costs and Economic Implications

Healthcare costs in the U.S. remain a major concern, with 8.95 million uninsured individuals—a number projected to rise to 37.2 million by 2028 (Shrank et al., 2021). The telemedicine market is expected to exceed $185 billion by 2026, offering opportunities to reduce costs and improve efficiency (Fortune, 2021). Telehealth visits can save $19–$21 per visit, while potentially avoiding 67% of ER visits, saving $32 billion annually (UHG, 2021). Benefits include lower hospital readmissions, reduced transportation costs, fewer medical errors, and improved patient outcomes.

Target Members of Congress for Lobbying

To advocate for telehealth policy reform, the following members of Congress should be approached:

These representatives possess the knowledge and influence to support telehealth legislation that addresses access, cost, and equity.

Recommendations for Solving the Problem

1. Establish Permanent Telehealth Policies: Ensure telehealth services remain available post-pandemic, focusing on rural and underserved areas.

2. Lift FQHC Restrictions Permanently: Allow more facilities to provide telehealth while maintaining best practices.

3. Grant Permanent Telehealth Licenses: Include a wide range of clinical practitioners such as psychiatrists, nutritionists, occupational therapists, speech pathologists, and physical therapists.

4. Expand Policy Flexibility: Allow the Secretary of Health and Human Services to implement case-based and priority-based policy relaxations, covering both video and audio services, Medicaid support, and subsidies to improve access and reduce costs.

Implementing these recommendations would improve healthcare access, reduce costs, and enhance health outcomes nationwide.

References

Bustos, C. (2021). Bustos helps pass $8.3 billion coronavirus funding package – congresswoman Cheri Bustos. Congresswoman Cheri Bustos. https://bustos.house.gov/bustos-helps-pass-8-3-billion-coronavirus-funding-package/

Chao, G., Li, K., Zhu, Z., McCullough, J., Thompson, M., & Claflin, J. et al. (2021). Use of telehealth by surgical specialties during the COVID-19 pandemic. JAMA Surgery. https://doi.org/10.1001/jamasurg.2021.0979

Fortune. (2021). Telemedicine market size, share, growth & trends [2020-2027]. Fortune Business Insights. https://www.fortunebusinessinsights.com/industry-reports/telemedicine-market-101067

Gajarawala, S., & Pelkowski, J. (2021). Telehealth benefits and barriers. The Journal For Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Hughes, P., Verrastro, G., Fusco, C., Wilson, C., & Ostrach, B. (2021). An examination of telehealth policy impacts on initial rural opioid use disorder treatment patterns during the COVID‐19 pandemic. The Journal Of Rural Health. https://doi.org/10.1111/jrh.12570

Jercich, K. (2021). In telehealth hearing, House committee weighs access against cost. Healthcare IT News. https://www.healthcareitnews.com/news/telehealth-hearing-house-committee-weighs-access-against-cost

Johnston, R., Kobb, R., Marty, C., & McVeigh, P. (2021). VA v

POLI 330N Week 7 Assignment: Final Project – Policy Issue

ideo telehealth and training programs during the COVID-19 response. Telehealth And Medicine Today. https://doi.org/10.30953/tmt.v6.241

Shrank, W., DeParle, N., Gottlieb, S., Jain, S., Orszag, P., Powers, B., & Wilensky, G. (2021). Health costs and financing: challenges and strategies for a new administration. Health Affairs, 40(2), 235–242. https://doi.org/10.1377/hlthaff.2020.0156

UHG. (2021). United Health Group report: Telehealth and ER utilization. https://www.uhg.com

Underwood, L. (2021). Healthcare policy and telehealth advocacy. https://underwood.house.gov

Wegermann, K., et al. (2021). Telehealth utilization in rural communities: Barriers and opportunities. Journal of Rural Health.

Shaw, R., et al. (2020). Telehealth services during COVID-19: Cost and accessibility evaluation. Journal of Telemedicine and Telecare.