August 15, 2016


Sue Ducat
Health Affairs
(301) 841-9962

Melissa Blair
Robert Wood Johnson Foundation
(609) 627-5937

Telehealth Parity Laws

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines telehealth parity laws in the United States. With 20 percent of Americans living in areas that have physician shortages, telehealth could help these underserved US residents obtain access to care, to treat illnesses as well as monitor chronic conditions. While the Affordable Care Act (ACA) includes efforts to encourage telehealth services as part of health coverage, it has only been implemented at the federal level through Medicare. Which, if any, telehealth services are covered by Medicaid still remains within the powers of individual states, with great variations from state to state. Telehealth parity laws would require reimbursement by health plans to providers at similar rates for services delivered in person or via telehealth. This policy brief looks at the obstacles telehealth faces in becoming a viable and cost-saving health care option for individuals and states.

Topics covered by this policy brief include:

  • What’s the background and the law? This section of the brief describes how telehealth works and its benefits to patients as well as the potential savings. As it notes, the federal government has shaped which telehealth services are covered under Medicare. Through Medicaid, almost all states provide reimbursement for live video telehealth—but, as the brief says, while many states mandate reimbursement, not all require reimbursement be made at the same rate as in-person services.

  • What’s the debate? With consumer demand for telehealth services on the rise, the brief describes the views of telehealth opponents who argue that these services are not equivalent, so should not be reimbursed at the same level. Opponents are also concerned that telehealth services could bring about improper diagnosis and treatment. The brief mentions past research, which addresses many of these concerns.

  • What’s next? The brief concludes that to reap the benefits of telehealth services, states are likely to move toward full parity laws for telehealth services. If there are no incentives to use telehealth, then providers will continue to focus on in-person care.

About Health Policy Briefs

Health Policy Briefs are aimed at policy makers, congressional staffers, and others needing short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

Previous Health Policy Briefs have addressed:

  • Regulation of Health Plan Provider Networks. Narrow networks have changed considerably under the Affordable Care Act, but the trajectory of regulation remains unclear.

  • Off-Label Drug Promotion. Drug companies are largely prohibited from promoting a drug for uses that have not been approved by the Food and Drug Administration.

  • Ambulance Diversion. Efforts to mitigate ambulance diversion have been effective, but questions remain for future progress.

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About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print and online, with additional Web First papers and health policy briefs published regularly at Read daily perspectives on Health Affairs Blog and customize the content you want to see in Health Affairs Alerts.

About the Robert Wood Johnson Foundation

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit Follow the Foundation on Twitter at or on Facebook at