Massachusetts Governor Charlie Baker has signed into law a telehealth bill that mandates permanent payment parity for telehealth services and established parity for primary care and chronic care management for the next two years.
After signing the bill on New Year’s Day, Baker said that the commonwealth – and the nation as a whole – needs to come up with a long-term plan to make telehealth a standard of care and pay providers for its use.
“I’ve thought for a long time that because as a country we underinvest in primary care and behavioral health services a lot of people who could be treated in the community end up in the hospital and we will basically have a chance here to study this question,” he said. “I think we’ll discover that by investing more or giving people more options to access care and supports they will stay healthier and spend less time in the hospital.”
The legislation pushes Massachusetts, long at the back end of telehealth policy and regulation, closer to the front of the pack. And it marks a victory of sorts for the Republican governor who saw a comprehensive telehealth bill that he’d introduced in 2019 get pushed aside by the coronavirus pandemic.
S.2984 was presented to Baker last week following days of intense negotiations in both the House and Senate. Aside from the parity provisions, it keeps in place many of the emergency measures enacted by Baker through the end of the ongoing public health emergency.
Baker said the law addresses a crucial issue in the Bay State: access to mental health services, especially for those struggling to adjust to the pandemic or dealing with substance abuse. It requires payers to cover all such services delivered via telehealth that are also offered in-person, and to reimburse providers at the same rate.
“This legislation continues to advance our shared goal of transforming mental health care access and delivery in Massachusetts,” State Senator Julian Cyr, co-chair of the Joint Committee on Mental Health, Substance Use and Recovery, said in the press release issued by the governor’s office. “This legislation will do so much good, but particularly it will expand mental health care access for rural residents, people of color, working families, and young people.”
As for primary and chronic care, Baker said the two-year provision gives the state and payers time to negotiate a long-term agreement on telehealth coverage. And with many states debating the same issue, those talks could attract a lot of attention.
Payers have traditionally been against payment parity for telehealth, saying they want the right to negotiate their own reimbursement rates with providers. Many telehealth advocates have also been reluctant to embrace payment parity, saying it may be good in the short run to get providers to embrace telehealth but won’t be feasible once value-based care concepts take hold.
Baker has said in the past that the healthcare industry has to shift its thinking from episodic care to care management, and to embrace preventive care measures that improve long-term health outcomes and reduce waste and excessive use.
Some of those ideas were included in his 2019 healthcare package, which was derailed by COVID-19. On the other hand, the crisis has helped to advance the value of telehealth.
“This is a little bit of a silver lining, the experience people had with some of these issues in 2020 and as a result the Legislature baked it into state law,” Baker said. “The concern that people always had with some of this stuff was whether it would be effective. Will it be useful? I think the practical experience helped get some people there.”
“Our health care community is spectacularly competent and tired, and I certainly think we will come back to some of these issues that were probably too big and too complicated to deal with in the context of what the last year was like, but not until after the pandemic,” he added.