Arkansas needs to advance telemedicine to improve access, lower costs

Health care is a pressing issue that continues to challenge every size of business, whether it employs 10 or 10,000. The problems are two-fold: cost and access. The Arkansas General Assembly has the opportunity to improve health care by passing HB 1220.

The ERISA Industry Committee (ERIC) represents the nation’s largest employers that provide benefits to millions of workers and families in every state, including Arkansas. Our member companies are household names and leaders in every sector of the economy. We advocate for them in their capacity as sponsors of health and other employee benefit plans for their own workforce. This mission is what brings us to Arkansas, where we have been engaged in the debate over the role of telemedicine in addressing cost and access since 2015.

The Arkansas General Assembly is currently considering legislation (House Bill 1220) that fully incorporates telemedicine as part of Arkansas’ health care solution. The approach offered in the legislation is particularly important in states like Arkansas that are largely rural, lack ubiquitous broadband access and are designated as medically underserved.

The proposed legislation maximizes the responsible use of technology to expand licensed physicians’ reach as they seek to provide timely, cost-effective care to patients with uncomplicated medical conditions by eliminating a medically unnecessary barrier to access. As proposed, HB 1220 would allow a patient located in the state to have a telemedicine visit with a physician, who is licensed in Arkansas, by using audio along with a review of the patient’s medical history, or by using video along with a review of the patient’s medical history.

ERIC has helped shape telemedicine policy in dozens of states where medical boards and legislatures are struggling to increase access to quality health care and contain costs. In 2017, Arkansas took a step toward deploying telemedicine when the Medical Board amended its rules to allow the establishment of the physician-patient relationship via telemedicine technologies, where previously an in-person meeting had been required. This was a huge step forward for Arkansas, but unfortunately that effort fell short when it left in place an ill-advised barrier to access by requiring that a patient’s first visit be conducted using video, rather than allowing the option of either video or audio – both in combination with access to a patient’s medical record.

Arkansas stands virtually alone in having such a barrier to care, and this “video-first” requirement is not supported by any clinical evidence. ERIC has consistently supported technology-neutral requirements. In our view, government policies cannot keep up with the changing pace of technology. But most importantly, technology-specific restrictions impede access to care.

With workers in every state, ERIC member companies are keenly interested in public policies that impact the health care available to their employees. Arkansas lags behind the rest of the country when it comes to fully utilizing telemedicine. In fact, all six states surrounding Arkansas allow for audio connections for all telemedicine visits, including the first, as long as the physician has access to the patient’s medical history. Forty-two states are entirely technology-neutral.

Large employers like ERIC members work hard to improve access to quality care in communities where their employees live and work. They champion onsite medical clinics, wellness programs, centers of excellence, patient-centered medical homes, and the use of technology to enable an individual to receive health care even when he or she is not in the physical presence of a provider.

Arkansas’ video-first mandate creates a significant gap in coverage for those who live in rural areas where broadband may not be available, those who are not computer savvy, and those who cannot afford access to broadband. HB 1220 moves Arkansas to the next logical and appropriate step in advancing telemedicine.

On behalf of our member companies and the working Arkansas families our companies support, ERIC calls on the General Assembly to swiftly approve HB 1220.

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Editor’s note: Annette Guarisco Fildes is President and CEO of The ERISA Industry Committee (ERIC), a national association that advocates exclusively for large employers on health, retirement, and compensation public policies at the federal, state, and local levels. The opinions expressed are those of the author.