NCDHHS Helps Make Telehealth More Accessible for Millions of North Carolinians

Tuesday, July 28, 2020

Since the start of the COVID-19 pandemic, teams within the NC Department of Health and Human Services have worked to ensure telehealth is easier to use for both patients and providers.

The COVID-19 pandemic has made telehealth the new industry standard for access to health care. Telehealth is the use of technology, such as using a laptop or smartphone, for health care appointments and services. It allows a patient to “see” their doctor without having to go to the doctor’s office.

Using telehealth for health care needs helps patients avoid exposure to COVID-19 while ensuring their overall health needs are still being met. 

In March, a DHHS Telehealth Workstream Team was created to help expand the use of telehealth. The group was led by Dr. Shannon Dowler, DHHS’ chief medical officer for NC Medicaid, and incorporated stakeholders from across the state, both internal and external to DHHS.

Their work has led to some outstanding accomplishments in the last few months. This includes allowing the expansion of telehealth to 2.1 million NC Medicaid beneficiaries; providing resources to patients and providers with the launch of a telehealth section of the DHHS website; and developing recommendations for the continuation of telehealth following the pandemic.

Historically, telehealth was limited to specialty care, such as telepsychiatry. Dowler and her team have worked since the start of the pandemic to ensure access to telehealth for Medicaid beneficiaries by implementing dozens of rapid policy changes that impact almost every provider type, from a routine physician visit to a lactation consultation.

Because of their work, NC Medicaid now allows providers to receive the same reimbursement, often referred to as “parity,” for a service regardless of whether it is provided in-office or via an approved technology platform using real-time audiovisual technology.

The types of Medicaid providers that can provide telehealth was expanded to include clinical pharmacists, licensed clinical mental health counselors, licensed marriage and family therapists, audiologists, optometrists and specialized therapists. The telehealth team held weekly Medicaid provider updates with around 1,400 colleagues from around the state joining to hear about and understand the rapidly changing telehealth landscape.

Since the NC Medicaid team started the work to make telehealth more accessible, many other insurers have also made changes to adopt telehealth solutions for patients.

“We need to continue to find ways to expand access to health care services for everybody, but especially for our most vulnerable populations, including the 2.1 million Medicaid beneficiaries across the state,” said Dowler. More information for Medicaid beneficiaries and providers can be found on Medicaid’s COVID-19 Guidance and Resources page.

The Consumer and Provider Engagement team, within the DHHS Telehealth Workstream, launched a telehealth section of the DHHS website in May with helpful resources for both patients and providers to increase equitable access to care through telehealth across the state. This team was led by Maggie Sauer, director of DHHS’ Office of Rural Health; Lakeisha Moore, rural health information technology manager in DHHS’ Office of Rural Health; Emma Sandoe, associate director of strategy and planning for NC Medicaid; and Karen Wade, policy advisor for DHHS.

“The COVID-19 pandemic has made telehealth essential for both patients and providers,” said Dowler. “The new DHHS telehealth section gives technical assistance, education and resources to providers to help them implement and expand telehealth, It also allows consumers and patients to find resources that answers their questions, making telehealth easy to use.” 

The website offers a number of webinars and virtual trainings to providers, announces upcoming telehealth events, and includes academic articles regarding the utility of telehealth during the pandemic on its education page.

There are also resources related to general health, billing, funding, behavioral health on the resources page, and providers can learn more about various telehealth partners and organizations on the technical assistance page. Patients can use telehealth to receive many services such as physical therapy, counseling or diabetes care, and can find more information on the patient/consumer telehealth resources page.

Other groups within the Telehealth Workstream also worked to improve telehealth for North Carolinians. The Data and Reporting team, led by Kelly Crosbie, director of quality and population health for N.C. Medicaid, studied the uptake and impact of telehealth and created a “hotspot” map to help the provider support teams with Area Health Education Centers (AHEC) and Community Care of North Carolina (CCNC) learn to use telehealth. The Preserving Gains team was led by Dr. Keith McCoy, DHHS’ senior medical advisor in the Chief Medical Office for Behavioral Health and IDD. This team created a list of telehealth service areas they recommended for policy prioritization, especially for vulnerable and historically underserved populations, after the pandemic ends.

“Improving access to telehealth is an essential tool in ensuring patients can access the health care services they need in the safest way possible during the COVID-19 pandemic,” said Dowler. “While great strides have been made, many communities continue to have inadequate or absent access to broadband. Our work is not yet done.”