How telehealth drives care improvement and saves money

Editor’s note: Leaders in Congress have agreed to a bicameral, bipartisan package of health care proposals that includes parts of the AMA policy agenda, including renewal of Medicare telehealth coverage for two years.

“The AMA commends congressional leaders for finding common ground,” AMA Board Chair David H. Aizuss, MD, said in an AMA statement that highlights other health care provisions. “As physicians, we know that the best results come from focused attention on what is best for patients. That’s what happened here.”

The AMA is laying out a comprehensive case for Congress to enact permanent authorization of Medicare telehealth services before a Medicare telehealth waiver expires Jan. 30.

With the current waiver deadline approaching, “Congress must finally act decisively to prevent a disruptive and abrupt halt to the expanded telehealth services that have improved care continuity, chronic disease management, and access for rural and underserved communities,” said AMA President Bobby Mukkamala, MD.

During the COVID-19 pandemic, Congress and the Centers for Medicare & Medicaid Services (CMS) expanded telehealth access by removing key barriers, including those related to audio visits and billing. However, repeated short-term extensions of these policies have created uncertainty for physicians and patients. 

“Treating them as stopgap measures rather than foundational tools undermines progress toward a modern, innovative and resilient health system,” says the AMA in its detailed issue brief, “The case for permanent telehealth policy and expanded access to virtual care” (PDF).

The brief outlines a series of actions Medicare and Congress should take to treat telehealth and digital medicine as essential care models, not alternatives. Specifically, the AMA is calling on the Congressional Budget Office (CBO) to factor into its projections the longer-term savings generated by telehealth. These include better chronic-disease management, and less use of costly emergency and inpatient services. 

Congress should work with the CBO to find an accurate budgetary score for permanent Medicare telehealth legislation, using updated real-world data and peer-reviewed research, says the AMA. 

From AI implementation to digital health adoption and EHR usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors. That includes recently launching the AMA Center for Digital Health and AI to give physicians a powerful voice in shaping how AI and other digital tools are harnessed to improve the patient and clinician experience. 

An invaluable lifeline

During the COVID-19 public health emergency and beyond, telehealth has proved its worth as a lifeline for patients and physicians alike. A 2022 federal study reported that more than 28 million Medicare beneficiaries used telehealth during this period, particularly for primary care and behavioral health. 

Other research has demonstrated this model’s ability to lower costs, expand access to care, reduce care fragmentation, and improve chronic disease management and overall patient outcomes. In addition, it has played an important role in mitigating the physician workforce shortage by reducing burnout and improving the efficiency of clinical tasks.

“Positive telehealth experiences increase patient engagement, encourage adherence to care plans, and reduce unnecessary emergency department visits or hospitalizations,” says the AMA issue brief. 

Studies have evidenced this, among them a 2023 Rock Health survey finding that 87% of telehealth users were satisfied with the experience, and 75% were interested in using telehealth again. Additionally, a 2022 JAMA Network Open™ study reported that telehealth led to 28% fewer emergency department visits among patients who used it within seven days of the onset of symptoms.

“Virtual access improves continuity of care and prevents minor issues from escalating into costly acute events,” says the AMA issue brief. This care modality also cuts financial burdens, saving fuel and parking costs, and public transit fares for populations with transportation challenges. Patients are also less likely to lose wages and incur child care expenses with a telehealth visit.

“As such, incorporating patient experience into telehealth cost evaluations ensures a more comprehensive and accurate assessment of its value and long-term sustainability,” the AMA says. 

AMA’s call for action

Congress’ evaluation of telehealth’s future has reached a critical point.

“Permanent telehealth reform is not only necessary to preserve the expanded access achieved during the pandemic, but it is also aligned with CMS’s broader digital transformation agenda,” the AMA issue brief says. In July, CMS announced its Health Tech Ecosystem Initiative, a program to develop an interoperable digital health infrastructure by 2026. 

“These efforts lay the groundwork for a patient-centric, tech-enabled health system, but cannot succeed without concurrent updates to coverage, payment and policy,” the AMA issue brief says. 

The AMA continues to press for permanent regulatory action on:

• Allowing teaching physicians to virtually supervise residents in both metropolitan and non-metropolitan areas.
• Prescribing controlled substances to patients who didn’t have an in-person evaluation with the physician.
• Medicare recognizing CPT codes for telemedicine evaluation and management services; and
• Lifting Medicare’s requirement that physicians report their home address if they provide telehealth services. 

Additionally, the AMA is calling on Congress to act various bills to advance telehealth. 

The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025 (H.R.4206/S.1261) would permanently remove restrictions on Medicare coverage of telehealth services. Examples of this include repealing the in-person requirement on telemental services, and allowing beneficiaries to do telehealth visits at home, regardless of geography.

The Hospital Inpatient Services Modernization Act (H.R. 4313/S.2237) would extend acute hospital at home waivers through 2030 for Medicare beneficiaries. 

The Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (H.R. 1523) would extend virtual services under the Medicare Diabetes Prevention Program for three more years.

The Connected Maternal Online Monitoring Act (S. 141) requires CMS to send a report to Congress that identifies Medicaid coverage barriers of remote physiologic devices such as pulse oximeters to improve maternal and child health outcomes for pregnant and postpartum women. 

Visit AMA Advocacy in Action to find out what’s at stake in supporting telehealth and other advocacy priorities the AMA is actively working on.