Leveraging Telehealth to Drive Health Equity and Expand Access to Care

Guest Authored by Sydney Etheredge - Director, Health Care Investment Program

With revenue from virtual visits in the U.S. on track to top 1 billion dollars by year’s end, it’s clear that the COVID-19 pandemic has created an opening for telehealth. Even before the pandemic though, the majority of consumers reported willingness to use telehealth, and patients have increasingly opted for telehealth services in recent years — particularly women, who across just about every age group, are the primary telehealth users.

Planned Parenthood health centers across the country have seen this surge in telehealth firsthand. Planned Parenthood has been leveraging technology to connect people to the care they need — wherever they are. At Planned Parenthood, telehealth is about connecting people where they are with the experts they trust. We’ve worked for years to scale our virtual visits and digital education tools to expand access to sexual and reproductive health care.

Innovating during a public health crisis amid barriers to care

During the COVID-19 pandemic, Planned Parenthood redoubled our efforts to ensure we can virtually provide critical sexual and reproductive health care and information to as many patients as possible. We are especially committed to access for patients for whom Planned Parenthood may be their only source of care, including people who are uninsured, people with low incomes, those who live in rural areas, as well as many people in communities of color and many who identify as LGBTQ+.

It’s important to note that innovations, like telehealth, provide new ways to access care — but do little to address the structural racism that has long kept the Black community and other people of color from getting basic health care in this country. Despite widespread interest in telehealth, many communities do not have access. Telehealth has disproportionately tilted towards wealthier patients and those with private insurance — a trend that continues during the COVID-19 crisis. According to one recent survey, the majority of new telehealth users were white, had insurance through an employer, had chronic conditions, and were middle-aged. Another recent study confirmed stark racial disparities in telehealth use for chronic disease management, with white patients accessing telehealth disproportionately more than Black patients, Latino patients, and Asian/Pacific Islander patients during the COVID-19 crisis.

As the health care system continues to change in the wake of COVID-19, stakeholders must avoid perpetuating its current barriers and inequities, including within the telehealth space. In just a few short months, telehealth has shown the potential to reduce barriers to care — such as needing to travel to a provider’s office or securing child care. As we look to the future, there’s an opportunity to consider the ways that telehealth can be leveraged to expand access and increase equity — particularly for women of reproductive age.

In one of the first comprehensive studies to ask women of reproductive age about their health care needs and preferences, Planned Parenthood found that sexual and reproductive health care services are among the top types of care that women of reproductive age need, and over half reported being interested in or open to using telehealth for reproductive health care services.

Opportunities to ensure equitable access to telehealth

But like many health care providers using telehealth, Planned Parenthood has run into barriers when providing this type of care, including low reimbursement rates and unnecessary regulatory and policy restrictions. It’s these barriers that have historically prevented the telehealth industry from reaching its full potential. Policymakers rapidly eased restrictions to allow for the broader adoption of telehealth during the pandemic, but we cannot let COVID-19 mark the end of the industry’s growth.

Health care stakeholders must prioritize solutions to address disparities in telehealth use, including language integration for limited English speakers and people with hearing disabilities, cultural competency among providers, and improved broadband access. Policymakers must ensure that all provider types can deliver clinically appropriate services via telehealth, that there is payment parity for all modalities, and that barriers to sexual and reproductive health care via telehealth, such as bans on the use of telemedicine to provide safe abortion are eliminated.

As we look to the future, it is imperative that telehealth be a part of the answer to expanding access to care and information for communities who have historically lacked access, rather than mirror the inequities of the current health care system.

About the Author
Sydney Etheredge, MPH is the Director of the Health Care Investment Program at Planned Parenthood Federation of America.  She oversees Planned Parenthood’s efforts to leverage health system transformation to improve coverage, quality, and access to sexual and reproductive health care, especially at the local and state level.

Editors Note: Alexis McGill Johnson, CEO of Planned Parenthood, recently sat down for a conversation with Ann Mond Johnson.  They spoke about how Planned Parenthood worked to expand its services to all 50 states in response to the pandemic, what makes them special as an organization, and thoughts about healthcare access and equity and how telehealth can support those efforts.  Listen to the full interview here.