Mouhamadou Ndiaye
Pronouns: He/him
Research Mentor(s): Antonios Koumpias
Research Mentor School/College/Department: Social Sciences, College of Arts and Sciences, University of Michigan-Dearborn / Other
Program: UROP
Session: Session 4 (1:40pm – 2:30pm)
Authors: Mouhamadou Ndiaye
Abstract
Historically, the US healthcare system has seen poor healthcare outcomes compared to similarly developed countries, despite mounting healthcare spending. These poor outcomes grew in severity during the COVID-19 Public Health Emergency ( PHE) as Medicare beneficiaries saw major disruptions in their care, particularly acute for Black patients ( Busch et al. 2022). In this climate of severe disruption, state policymakers scrambled to enact alleviating legislation. Telehealth waivers represent such legislation. Prompted by the COVID-19 PHE, state medical boards decided to temporarily or permanently waive Telehealth physician supply and patient demand restrictions. These range from licensure restrictions to out-of-state physicians in supplying mental health services, changes in reimbursement for Telehealth delivery of services (payment parity), and relaxation of potential HIPAA penalties for good faith use of Telehealth. While the COVID-19 pandemic wanes and with it, the Telehealth waivers, poor healthcare outcomes, shortages, and disparities still remain. In an effort to inform the post-PHE policy landscape, this study aims to identify the determinants of state policymakers’ decisions to waive, temporarily or permanently, regulatory barriers that restrict access to beneficial Telehealth. We combine state-level information on Telehealth policy variation from the Federation of State Medical Boards and the Center for Connected Health Policy before and during the PHE with predictors of legislative changes from the Center for Poverty Research at the University of Kentucky, the Kaiser Family Foundation, and the Area Health Resource Files from CMS to identify determinants of in-state licensure requirements, pre-existing relationship requirement waivers, and the introduction of private payer laws and payment parity. Using standard two-way Fixed Effects models, we estimate the association between regulatory, healthcare supply information, and socioeconomic characteristics and the probability of waiving patient-physician pre-existing relationship requirements, extending payment parity, and reinstating in-state medical licensure requirements
