AAFP: Telehealth Policies Provide Opportunities but Need Improvements

Recently, the American Academy of Family Physicians (AAFP) wrote two letters to Congress requesting a new program that integrates behavioral healthcare into primary care with telehealth, more clarity regarding payment, further protection around patient-provider relationships, and the ability to refer and prescribe virtually. 

AAFP, a national association of family doctors, represents 127,600 physicians and medical students nationwide.

Recently, the Senate Telehealth Working Group and the House Telehealth Caucus announced plans to reintroduce the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act. After receiving a request to provide feedback, the AAFP wrote two letters detailing their opinion.

AAFP first noted that Congress must consider how payment practices can be further simplified.

“Congress should create policies that strengthen patients’ relationships with their primary care physician, and physicians should not be paid less for providing patient-centered care,” said the AAFP in the letter. “Payment should reflect the equal level of physician work across modalities while also accounting for the unique costs associated with integrating telehealth into physician practices.”

The academy also emphasized the need to address behavioral health needs through the revision of telehealth legislation. Their recommendations include the permanent removal of geographic and originating site restrictions, requirements for in-person visits prior to telemental health visits, and telehealth restrictions on alternative payment methods.

Further recommendations include the establishment of a digital health equity pilot program to fund digital health literacy programs for patients, digital health navigators, and digital tools with non-English language options; and a program that mirrors the Health Resources and Services Administration Pediatric Mental Health Care Access program to further integrate behavioral health pediatric primary care.

Additionally, the academy noted that the expansion of telehealth that began in 2020 resulted in a need to protect the physician-patient relationship.

“The AAFP strongly urges Congress to ensure that the policies contained within this legislation do not inadvertently provide a pathway for direct-to-consumer telehealth vendors to disrupt the comprehensive and longitudinal relationships between patients and their primary care physicians,” noted the letter from the AAFP.

The academy also noted that prescription drugs should only be advertised based on the health condition without mentioning the name of the medication and that providers should be able to prescribe virtually.

“The Academy strongly supports expanding access to behavioral health services delivered via telehealth,” the AAFP told the Department of Health and Human Services, the Food and Drug Administration, the Federal Trade Commission, the Department of Justice, and the Securities and Exchange Commission. 

Finally, the academy urged Congress to advance health equity by analyzing telehealth use and patient outcomes by race, ethnicity, geographic region, income level, gender, and language, and solidifying the Centers for Medicare and Medicaid Services’ coverage of audio-only telehealth.

The AAFP joins several healthcare stakeholders in advocating for permanent telehealth legislation.

This month, the American Hospital Association (AHA) wrote a letter to the Senate and House of Representatives requesting the elimination of restrictions on telehealth services for Medicare beneficiaries.

Specifically, the letter included feedback on the CONNECT for Health Act, noting the association's support for making pandemic-era telehealth flexibilities permanent. Along with this, the letter encouraged bill sponsors to consider the factors that enabled the increased adoption and use of telehealth amid the pandemic.