CHAPEL HILL, N.C.--The onset of the COVID-19 pandemic has broadly affected how health care is provided in the United States. One notable change is the expanded use of telehealth services, which have been quickly adopted by many healthcare providers and payers, including Medicare, to ensure patients' access to care while reducing their risk of exposure to the coronavirus.

In an article published in JAMA Oncology, Trevor Royce, MD, MS, MPH, an assistant professor of radiation oncology at the University of North Carolina Lineberger Comprehensive Cancer Center and UNC School of Medicine, said the routine use of telehealth for patients with cancer could have long-lasting and unforeseen effects on the provision and quality of care.

"The COVID-19 pandemic has resulted in the rapid deregulation of telehealth services. This was done in part by lifting geographical restrictions, broadening patient, health care professional, and services eligibility," said Royce, the article's corresponding author. "It is likely aspects of telehealth continue to be part of the health care delivery system, beyond the pandemic."
The article's other authors are UNC Lineberger's Hanna K. Sanoff, MD, MPH, clinical medical director of the North Carolina Cancer Hospital and associate professor in the UNC School of Medicine Division of Hematology, and Amar Rewari, MD, MBA, from the Associates in Radiation Medicine, Adventist HealthCare Radiation Oncology Center in Rockville, Maryland.

Royce said the widespread shift to telehealth was made possible, in part, by three federal economic stimulus packages and the Centers for Medicare and Medicaid Services making several policy changes in March that expanded Medicare recipients' access to telehealth services.

The policy changes included allowing telehealth services to be provided in a patient's home. Medicare previously only paid for telehealth services in a facility in nonurban areas or areas with a health professional shortage. Medicare also approved payment for new patient appointments, expanded telehealth coverage to include 80 additional services, allowed for services to be carried out on a wider assortment of telecommunication systems - including remote video communications platforms, such as Zoom - and modified the restrictions of who can provide and supervise care.

While the potential benefits of telehealth have been demonstrated during the pandemic, Royce said they must be balanced with concerns about care quality and safety.

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