During the pandemic, many of us in the health care field have witnessed how a new-fashioned doctor’s telephone “house call” has become crucial to expanding health care access and health equity long after COVID has been conquered. But our ability to continue providing that care is threatened.
Planned Parenthood Mar Monte staff often hear from our patients — most of whom have incomes barely above the poverty level and face stark health care disparities — that they completely rely on telehealth visits. In fact, half of all our patient visits in the past year have been via telehealth, primarily audio, due to the pandemic. That’s what our patients prefer.
Still, the Centers for Medicare and Medicaid Services and California’s Department of Health Care Services want to decrease or eliminate reimbursements for audio telehealth services under the theory that when the pandemic is over, patients can easily go in to the doctor’s office. But the truth is that many of these patients can’t and never really could. Not easily.
It’s also a myth that all care in the exam room is better than audio telehealth. There are many kinds of preventive care services that can be done just as effectively or even more effectively when a patient doesn’t have to come in.
At PPMM, all of our primary care services were converted to telehealth early in the pandemic. There has been no decline in those health outcomes, and, in some cases, the outcomes are better. In fact, 85% of all of our telehealth patients have requested phone-only appointments, and all telehealth patients have reported a 90% satisfaction rate with their visits, based on survey results done by an independent company.
Here are some everyday stories of health care that’s cutting-edge — because it happened with our patients and clinicians entirely on the phone:
An elderly man with diabetes, who can’t take public transportation, has regular audio telehealth appointments to manage his symptoms and medication. Now his blood sugar levels are under control without him having to make an arduous trip to the doctor’s office.
A mother who has small children at home and no childcare speaks on the phone with her family doctor to treat her hypertension and anxiety issues, still receiving the counseling she relies on to stay healthy.
A woman who is slowly recovering from hospitalization for pneumonia speaks weekly with her physician to monitor her symptoms and adjust her medication. She is safely recuperating at home — and staying out of the emergency room.
There are thousands of stories like these from all over the state. The California Legislature is now considering a bill, AB 32 (Assemblywoman Cecilia Aguilar-Curry, D-Winters) that maintains payment parity in Medi-Cal reimbursements for all telehealth services, and legislators should support it.
Earlier this year, PPMM’s Chief Medical Officer Dr. Laura Dalton testified to lawmakers that telehealth remains essential to her patients because long-existing barriers, ranging from lack of transportation to inflexible work schedules, make it difficult to get the health care they need and deserve.
“Going back to health center visits when they are not indicated or requested by the patient is harmful,” Dr. Dalton testified. “And I cannot imagine a system that would tell me, as a primary care provider, that I must do something that I think is not in the best interest of my patients’ lives.”
All telehealth services must be equally funded as a matter of justice. We urge health care policy makers to listen to patients and health care providers– and do no harm.
Stacy Cross is president and CEO of Planned Parenthood Mar Monte.