Uncertainty clouds the discussion of how the U.S. should fight the spread of the COVID-19, the flu-like respiratory disease that originated in China in December and was first reported in the U.S. in late January. Now, more than a month later, there’s cause for greater concern as the virus continues to spread across the country. As of the publication of this piece, the U.S. had 1,323 confirmed cases. In the face of so many unanswered questions, one thing is certain — the number of cases will increase. State governments should make sure they eliminate any barriers that may hinder a patient’s access to care or increase the burden on the health care system.
According to the CDC, the virus is spread “mainly between people who are in close contact with one another — within about six feet — through respiratory droplets produced when an infected person coughs or sneezes.” For a disease such as COVID-19, telemedicine visits offer several benefits that in-person care cannot. However, state law currently prohibits a North Carolina patient from seeing a doctor who is not currently licensed in the state. This means North Carolinians’ access to a licensed doctor via telemedicine stops at the state boundaries, despite the numerous, well-qualified professionals ready to help via video chat.
For example, CVS Minute Clinic offers a $59 video visit. But patients in North Carolina who would prefer to see a physician via video chat, rather than go out in public to an urgent care or hospital, don’t have that option. Choosing North Carolina in the drop-down bar on the CVS website brings patients to a page with a message that reads, “Video visits are not available in your state.” We know the number of test kits, and for that matter resources in our health care system, are scarce. Therefore, we should allow both in- and out-of-state licensed physicians in good standing to diagnose patients virtually. This would decrease the burden on the health system as a whole.
Top health officials at the Centers for Disease Control , the Centers for Medicare and Medicaid Services, and the North Carolina Department of Health and Human Services have all recommended that providers and patients leverage the use of telemedicine for diagnosis. Using telemedicine will help patients get properly diagnosed, allow patients another means of accessing the health care system, and better allocate the available resources.
The private sector has already stepped up to help. The trade group for health insurance plans, America’s Health Insurance Plans, recently announced that its members would cover needed diagnostic testing for people seeking testing and treatment for the virus. Similarly, Blue Cross Blue Shield of North Carolina announced it will increase its virtual access to doctors through telemedicine, expediting approvals for acute care, and help patients get appropriate amount of the medication. Their willingness to pay means little, however, if regulations prevent access to video visits and telehealth in the first place.
But some private sector actors may be hindered in their efforts to step up and help. North Carolina still regulates the building and expanding of health facilities through a certificate of need program. A government permission slip will be needed for the purchase of new equipment or the addition of new beds that expand capacity beyond 10%. It’s almost certain the number of cases is going to increase; therefore, the state would be wise to make sure that existing health facilities are free to change the number of beds in their existing facility without needing government permission. Given the speed in which the virus is spreading, providers may need to act without waiting for government approval.
As questions about the scale and impact of the virus remain unanswered, our state can take steps to increase the access patients have to medical professionals while also decreasing the burden on our health care system. Starting with waiving restrictions regarding telemedicine and certificate of need, we can ensure that there are as few government barriers as possible as to allow the private sector to aid public health officials.