Payment and Coverage Parity for Virtual Care and In-Person Care: How Do We Get There?

Area of Science:

• Healthcare Policy
• Telehealth Research
• Health Economics

Background:

• The COVID-19 public health emergency (PHE) saw increased virtual care due to relaxed payment and coverage rules.
• The conclusion of the PHE has created uncertainty about ongoing payment and coverage for virtual care services.

Purpose of the Study:

• To address the critical need for payment and coverage parity for virtual care services.
• To explore strategies for achieving pay parity between virtual and in-person care.

Main Methods:

• A panel discussion at the Third Annual Virtual Care Symposium focused on payment and coverage parity.
• Experts discussed current policies, state licensure laws, and evidence on virtual care outcomes, costs, and resource utilization.

Main Results:

• Discussions highlighted key issues in achieving payment and coverage parity for virtual care.
• Next steps were identified to influence policymakers, payers, and industry groups to support parity.

Conclusions:

• Legislators and insurers must establish coverage and payment parity between telehealth and in-person care.
• Further research on clinical appropriateness, equity, access, and economics is essential for virtual care's sustainability.