ABSTRACT: Background: The COVID-19 public health emergency increased demand for healthcare services, prompting emergency policy changes that expanded access via telehealth. Objective: To identify determinants of state telehealth policies related to in-state licensure waivers and payment parity. Methods: A retrospective, longitudinal analysis of monthly state telehealth policy changes between January 2020 and December 2022 was conducted. Multivariate logistic regression was used to estimate the relative importance of public health, state health policy and socio-economic factors for waiving in-state licensure requirements or implementing payment parity. Results: Waiver implementation and maintenance were more likely in ACA expansion states, states with higher COVID-19 elderly mortality rates, and increased new health center market entry but less likely in states with Democratic governors, Interstate Licensure Compact participation and Certificate of Need laws. Payment parity was more likely in states with Democratic governors, higher elderly vaccination rates, and CON laws, but was less likely in IMLC states. Conclusions: The adoption and maintenance of telehealth policy changes was influenced primarily by public health shocks and health policy factors, as well as the political orientation of state governors. Comparatively, socioeconomic conditions were less influential.
Antonios M. Koumpias (Fri,) studied this question.