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The COVID-19 pandemic has highlighted limitations in access to healthcare. During the current public health emergency (PHE), Medicare, private insurers and state licensing boards have made policy changes liberalizing reimbursement for telehealth. Historically, Medicare and large private insurers (in the US) have presumed information technology (IT) fluency by patient populations. However, data demonstrate that there are numerous populations who demonstrate very limited utilization of IT for accessing healthcare, including older adults. These data demonstrate the importance of assessing IT utilization to make healthcare accessible to individual patients, and to better understand patterns of IT utilization among groups with historically low IT utilization. Under pressure from medical and consumer groups, Medicare and private insurers allowed reimbursement for telephone-only virtual visits during the PHE, but indicate that termination of the PHE will be coupled with termination of more liberal telehealth policies. In addition, Medicare and private insurers continue to seek loopholes allowing exclusion of various types of telehealth, which will make telehealth (and healthcare) inaccessible to the most vulnerable populations, including older adults. Recommendations are made for assessment of IT utilization as part of routine patient intake assessment, in order to make healthcare accessible, improve communication between patients and healthcare providers, and to improve treatment outcomes. Recommendations are also made for permanent telehealth policy changes that will make healthcare more accessible to at-risk populations.
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