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As shelter-in-place orders swept the U.S. during the coronavirus pandemic, healthcare providers’ implementation of telehealth expanded rapidly.
In telehealth sessions, those seeking routine check-ups, mental health care, or other services can meet with their provider virtually using computers or other smart devices. This novel way of treating patients aims to look for ways to deliver care to patients in their homes to limit the transmission of the novel coronavirus.
“The current public health emergency and the resulting accelerated growth potential in telehealth services is an opportunity for providers to enhance their care practices and for insurers and policymakers to recognize the value of telemedicine,” a recent report from UCLA’s Center for the Study of Latino health and culture states.
Growth of a New Form of Telehealth Care
Despite the explosion of new technological advances over the past decade, virtual care for mental health services was a bit of a rarity.
“Before COVID, fewer than 10% had ever used it, and now with Covid-19, a lot more people have tried it, and increased use of telehealth may also help drive down costs by expanding health plans’ networks of doctors and other providers and creating greater competition,” Sam Glick, a leader of the Oliver Wyman Health Innovation Center told Bloomberg Law.
Still, with the outbreak of the current novel coronavirus, government officials began to supply providers with support for new ways to treat patients.
“The federal government and many states issued regulations or enacted emergency laws to raise reimbursement rates for providers and ease restrictions, such as licensing requirements, to expand telehealth access,” Sara Hansard, a reporter with Bloomberg Law writes.
On the federal level, a new bill—Helping Ensure Access to Local TeleHealth, or HEALTH Act—is being introduced in Congress, which would provide for permanent Medicare payments for telemedicine services at federally qualified health centers and rural health clinics.
The Federal Communications Commission’s Wireline Competition Bureau recently approved an additional 62 funding applications for the COVID-19 Telehealth Program.
“In response to the pandemic, the Centers for Medicare and Medicaid Services (CMS) released guidance in early March encouraging states to expand their telehealth services and offer providers more flexibility in virtual service delivery,” Osub Ahmed with The Center for American Progress writes.
Still, this new form of care isn’t helping everyone equally, according to Dr. Leonor Corsino, an associate professor of endocrinology, metabolism, and nutrition at the Duke University School of Medicine.
“Many health care organizations have moved to telehealth, which further highlights the disparities in access to quality care,” Corsino writes in an editorial in the Charlotte Observer.
“Although telehealth is an amazing resource, Hispanic patients are struggling to access this resource. Some lack health insurance or access to health care institutions that offer telehealth. Others lack access to the technology and have limited ability to speak with English-speaking providers.”
Telehealth and Latino Perspectives During COVID-19
For example, in Kansas, 15.1% of COVID-19 deaths are Latino, a higher percentage than the general state Latino population of 12.1%. Local reports suggest that language barriers pose a steep hurdle as Kansas governments try to overcome the pandemic. Over half of the state’s 329,000 Latinos speak Spanish at home.
In California, where there is also a COVID-19 disparity, The UCLA Latino Policy and Politics Initiative report suggested that “more than 7 million Latinos in California could receive improved access to health care through an expansion of telehealth.”
The report also suggested the following key points:
- “Policymakers must enact ways to ensure barriers such as broadband connectivity and infrastructure do not limit access for vulnerable patient populations.”
- “Physicians have been using telephone calls to support patient visits with individuals who lack necessary tech resources, but “lower rates for telephone visits have created financial hardships for practices and disproportionately affected physicians who care for Medicare beneficiaries and underserved patients.”
- “In California, about 44 percent of the population speaks a language other than English, but Spanish-speaking physicians are most under-represented in the workforce; policymakers must incorporate medical interpreter use into telehealth tech to ensure language concordance is addressed.”
- “Evaluation measures for telehealth programs must be established to properly assess the quality of telehealth services, including safety, availability, and accommodation of care for limited-English proficient populations.”
The report authors also emphasize that the COVID-19 outbreak is hitting hard to the safety-net clinics serving medically in underserved and rural areas. These areas are “facing alarming drops in Medicaid and Medicare reimbursements as a result of the drop in face-to-face consultations.”
To ensure strong policies while combating the crisis to serve every California community best, the state must put forward more policy changes in regards to telehealth access to address the vulnerable population.
Why is Healthcare and Telehealth Important for Latinos?
Federal data suggest that only one in 10 who enrolled for healthcare coverage via HealthCare.gov were Latino, a lower rate than their black and white peers.
According to the poll from the Associated Press-NORC Center for Public Affairs Research, more than 60% of U.S. Latinos struggle to communicate with a healthcare provider due to a language or cultural barriers.
“Thereby, the COVID-19 crisis has emphasized the critical need to address and improve the underlying inequity issues among Latino patients,” Dr. Hector Colón-Rivera, an addiction psychiatrist and medical director of the Asociación Puertorriqueños en Marcha Behavioral Health Program, a nonprofit organization based in the Philadelphia area, told Medscape.
How Can You Step Up to Raise Awareness of Inequities During the Pandemic?
Policy recommendations must be made at the community to the federal level to make sure that all patients have access to quality care.
“By building a foundation for widespread and inclusive telehealth implementation, policymakers can ensure our healthcare workforce can meet the needs of all patients, especially those residing in linguistically and medically underserved communities,” UCLA’s Center for the Study of Latino health and culture report states.
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