Critical Access Hospital Telehealth Guide

Telehealth has been used as a modality to deliver health care services for over six decades, but its potential to expand access and keep people safe came sharply into focus during the COVID-19 pandemic when using telehealth became an imperative. Critical Access Hospitals (CAHs) have multiple options to expand and optimize telehealth service to meet the quadruple aim – now expanded to the quintuple aim.

Improve patient health and outcomes by better disease management, monitoring, and timely care

Reduce health care costs by fewer emergency department (ED) visits, admissions, and readmissions

Enhance the patient experience by expanding access, improving convenience, coordinating care, and building relationships

Enrich the work-life of staff by providing more options to optimize health care service delivery, enhancing flexibility in work locations and schedules, and serving patients in ways that are better for everyone.

The CAH Telehealth Guide provides practical guidance on implementing and sustaining telehealth to optimize health care delivery, expand access, enhance care coordination, and address health inequity. Note that this is not an all-inclusive policy guide for telehealth. Just as health care organizations strive to take a person-centered approach to health care, this guide seeks to take a CAH-centered approach to telehealth that keeps the patient and community at the forefront. The target audience is any individual, team, or organization seeking to implement or expand telehealth services in the CAH setting. The guide primarily focuses on Medicare outpatient telehealth services but includes Medicaid coverage and remote services that may not strictly be considered telehealth.

Readers are encouraged to review state-based telehealth policy details at the Center for Connected Health Policy (CCHP), which provides detailed state Medicaid agency telehealth details with helpful links to each states’ relevant resources, manuals, statutes, etc.

Because telehealth policy is currently in flux, when appropriate, the guide identifies temporary allowances resulting from the public health emergency declaration (PHE) in gray callout boxes. There is broad support by health care industry leaders, including the American Medical Association, to maintain many of the flexibilities allowed under the PHE. Check CCHP’s Telehealth Legislation & Regulation site to track telehealth state legislation and regulation across the nation for the current legislative session.