HIV Specialist - March 2021 - 18

require broad stakeholder engagement and significant policy dialogue.
Ensuring adequate and appropriate reimbursement for the varying range of telehealth
services:ARE
Providers,
rightfully,
be assuredTHE
adequate
reimbursement to sustain their
TELEHEALTH SERVICES
A VITAL
TOOLneed
FORtoENDING
HIV EPIDEMIC
practices, but also to make needed investments in technology and practice transformation. This
issue is complex, and providers and insurers have competing interests. Some states require parity

Ensuring adequate and appropriate reimbursement for the
varying range of telehealth services: Providers, rightfully, need to
be assured adequate reimbursement to sustain their practices, but also
to make needed investments in technology and practice transformation. This issue is complex, and providers and insurers have competing
interests. Some states require parity of reimbursement with in-person
services provided in a clinic.7 Payers and policymakers often assert, however, that actual costs for telemedicine services are lower than in-person
services and wish to reimburse these services at lower costs.8 Further, do
current reimbursement practices differentiate between high-intensity
telehealth services and low-intensity services? Or do they account for
provider time spent e-mailing patients that may now require much more
time than in the past? Going forward, ensuring adequate reimbursement
may be contentious and may require new or more innovative billing
models than those that currently exist. HIV providers must be engaged
in this dialogue both with healthcare programs and health plans.
Using the deployment of telehealth to increase equity for patients
and clinical practices: The field of HIV care has been ahead of the
country in recognizing inequities in access to care and achieving good
outcomes. But the inequities within our communities remain large and
include disparities for low-income people, people in rural areas and people
of color. Further, the providers and practices serving these communities

MARCH 2021

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can also be disproportionately under-resourced.
This phenomenon, known as the Digital Divide,
impacts providers as much as patients. For
patients, some lack access to phones or have
inadequate minutes or data on cell phone plans
while others do not have reliable access to
broadband internet. Services providers may also
lack technical, financial and other resources
to implement telehealth. To overcome these
barriers, there will need to be increases in funding, training and innovative solutions. Using
telehealth adoption to reduce inequities needs
to be at the top of the agenda for HIV providers
and the broader HIV community.

Policy Actions are Needed
to Support Telehealth
Sustainability

Telehealth can shift from an emergency
response to a more permanent component of
HIV care delivery. While many policy actions
are needed, it is important to keep in mind
four critical goals:

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HIV Specialist - March 2021

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