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A patient must have three monthly in-person visits before beginning telehealth encounters. The only stipulation centered on frequency. The legislation allowed patients receiving home dialysis to opt for telehealth with home as the originating site and without geographic restriction. Telehealth was available to patients on home dialysis as early as 2019 under the Bipartisan Budget Act of 2018 ( 6). However, this created the challenges of working within numerous nonintegrated applications to conduct video visits, document care, and complete practice management activities (compliance, billing, coding, payment collection, etc.). The waivers allowed almost any convenient video platform to be used for telehealth, forgoing many privacy and security requirements that created barriers for practices to implement telehealth quickly and cost effectively. In addition, CMS provided payment for video and phone visits. States waived state licensure requirements for cross-state practitioners as long as they held an active state license in any state. Both patients and outpatient practices quickly adapted to telehealth once Centers for Medicare & Medicaid Services (CMS) issued waivers lifting geographic restrictions and expanding originating and remote sites to home ( 5).

Providing or receiving an in-person doctor visit became a challenge for the clinician and office staff and patient, respectively, when social distancing and stay-at-home policies were endorsed in 2020 due to the COVID-19 pandemic. Limitations existed for both the originating and remote sites that created barriers for patients to access care via telehealth and disincentivized clinicians to offer telehealth as an option. We have drawn similar conclusions from our own work evaluating telehealth programs in patients with kidney failure ( 2).īefore the coronavirus disease 2019 (COVID-19) pandemic regulatory waiver–induced surge in usage, telehealth was available to US Medicare beneficiaries if they did not live in a metropolitan statistical area, or if they did, the area was rural and in a Primary Care or Mental Health geographic Health Professions Shortage Area and had limited adoption ( 3, 4). This article demonstrates that care via telehealth has better or comparable patient clinical outcomes, health care utilization, efficiency measures, and patient- or physician-reported outcomes measures such as satisfaction. The application of telehealth in patients with CKD and kidney failure being treated with dialysis or kidney transplant was evaluated in selected studies by Young et al.

Although much enthusiasm exists for the use of telehealth to improve access to care, identifying how to optimally utilize this tool remains a priority. The provision of health care remotely by means of telecommunications technology defines telehealth.

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