Telehealth & Health Plan Accreditation

COVID-19 really outdid itself this year.

It severely restricted patients’ access to in-person care with roughly 70% of in-person visits being cancelled. Once that happened, there was a massive adoption of telehealth. According to McKinsey, consumer adoption of telehealth increased from 11% in 2019 to 46% during the pandemic. This shift has led to increases of more than 50-175 times in telehealth visits as reported by health systems, primary care and behavioral practices.

In other words, telehealth became a big deal fast.

Although telehealth has the potential to improve outcomes and access to care for 60 million individuals, there are still some concerns. Telehealth can potentially extend existing issues such as fragmented care, poor care coordination and disparities. NCQA believes that to give payers, purchasers and consumers greater confidence in telehealth services, it is important to standardize expectations around patient safety, access and delivery of high-quality services while giving plans the ability to innovate on other important aspects of telehealth service delivery.

In other words, we need to establish what quality telehealth looks like. NCQA is already in the business of working to ensure quality. In addition to Health Plan Accreditation, NCQA offers modules and Distinctions for organizations that want to demonstrate that they can deliver high-quality services in:

  • Long-Term Services and Supports (via LTSS Distinction).
  • Medicaid plan compliance with the Medicaid Managed Care Rule (via the Medicaid Module).
  • Medicare Advantage plan compliance (via the Medicare Advantage module).

NCQA proposes a Telehealth Module in Health Plan Accreditation to help plans demonstrate that their telehealth networks provide safe, equitable and coordinated care by credentialed physicians. For employers, managed care states and other purchasers, this Module will offer visibility into the quality of a plan’s telehealth services and networks.

How You Can Help

Time and time again, we like to remind you that your opinion matters to us. So, we urge you to participate in our Telehealth HPA public comment. Public comment is integral to the development of NCQA standards and measures. Don’t wait. You have until December 18 to click here to give your recommendations to help us ensure quality telehealth for all.