Telehealth Bolstered Finances of California Medicaid Providers

Sixty percent of Medicaid providers in California said that telehealth provided financial stability for their organization, a new report shows.

The report was released by Health Net, a payer supporting members on Medi-Cal, California's Medicaid program. In 2020, Health Net awarded 138 Medi-Cal providers about $13.4 million in grants to implement and expand telehealth services. The grant period was from May 2020 to April 2021, after which the grantees submitted information about how they used their funds. The new report is a summary of the reports submitted by 98 Medi-Cal providers.

Overall, telehealth use among Medi-Cal patients increased from 2 percent of all doctor visits prior to the pandemic to 45 percent at the end of 2020, representing a 20-fold increase.

A majority of the providers (68 percent) used the grant money to enhance their technological infrastructure, supporting the spike in telehealth use among Medicaid patients. Thirty-one percent of grantees used the funds to support telehealth training for providers.

The providers used telehealth for several different types of care. About 31 percent of grantees used telehealth funding to support preventive care, such as routine checkups, while 42 percent identified the care modality as a key tool for patient screenings, including screenings for chronic diseases like diabetes.

Approximately 17 percent of the providers offered health education through telehealth, including nutrition and physical activity counseling, and smoking cessation, and 16 percent offered telemental healthcare.

Though 60 percent of providers agreed that integrating telehealth into care delivery supported the financial stability of their organization, 28 percent noted challenges they faced getting reimbursed for these services. The most commonly cited challenge was a lack of standardized billing practices.

Providers also cited several challenges to expanding access to telehealth services. Patients' ability to access technology/internet (82 percent), providers learning how to use new technology (24 percent), and patients preferring in-person care (12 percent) were the top three barriers cited.

A small percentage of providers cited patient privacy concerns (7 percent) as a telehealth challenge as well.

Despite these hurdles, a vast majority (87 percent) of providers indicated that they plan on integrating telehealth "as a sustainable practice for patient care," the report stated.

"As we evolve in this new approach to healthcare, there is certainly a learning curve that is allowing us to strengthen and develop best practices, especially in the area of accessibility to 'hardly reached' low-income communities; and provision of virtual care in a culturally competent manner that is universally available to all patients, including those who are best served in a non-English, primary Spanish language," one provider said, according to the report.  

But the piecemeal nature of policies governing telehealth at the state level could pose problems for providers caring for vulnerable populations.

A report published last November shows that though every state and Washington D.C. offers Medicaid reimbursement for some form of telehealth, policies vary depending on the modality. For example, some states only reimburse services with certain CPT codes while others reimburse all appropriate services that are covered under Medicaid.

States also have differing policies with regard to licensure and in-person requirements, creating barriers to virtual care adoption and provision across the country.