Impact of Audio-only Telephone in Delivering Health Services During COVID-19 and Prospects for Future Policies & Medical Board Regulations

The COVID-19 pandemic and resulting public health emergency (PHE) has severely impacted every aspect of life, including healthcare. As a result of the stay-at-home orders, telehealth has been pushed into the center of the healthcare delivery system. Over the last year, many Americans have been introduced to and become familiar with telehealth as an effective and safe tool to access healthcare. However, not all patients have been so lucky. The necessity to utilize telehealth in healthcare delivery has brought to light the digital divide in America, specifically for older, low-income and minority populations. For example, more than one in three US households headed by a person age 65 or older do not have a desktop or laptop, and more than half do not have a smartphone. Additionally, these groups are also less likely to be digitally literate.1 Preliminary studies have found that these groups are also at higher risk for COVID-19, and suffer serious illness at a higher rate.2 To address this digital divide, policymakers have temporarily allowed audio-only telephone to be used to deliver certain services in Medicare and many Medicaid programs. The Federation of State Medical Boards Foundation (FSMB Foundation) provided funding to the Center for Connected Health Policy (CCHP) to conduct a study that examined the use of audio-only as a modality
to provide services from a federally qualified health center (FQHC) to patients in the Medicaid program.