Broadband access, outdated laws among hurdles to equitable telehealth, says NCQA

The National Committee for Quality Assurance released a white paper this week exploring the root causes of disparities in virtual care access.  

The report, which grew out of an NCQA roundtable discussion on the future of telehealth, outlines existing barriers to equity and recommendations for improving care delivery.  

“Even prior to the pandemic, a change in healthcare delivery was on the horizon with ever-evolving advancements in technology,” said NCQA President Margaret E. O’Kane in a statement.   

“As virtually based care expands, unique patient needs and preferences must be identified and prioritized so that telehealth can help us close the gaps in health care and not widen existing disparities,” O’Kane continued.  


The spike in telehealth use triggered by COVID-19 has prompted examinations of its potential role in both expanding access to and enacting hurdles to care.  

In October 2021, NCQA hosted a roundtable discussion that included a multidisciplinary panel of experts in telehealth practice, technology, regulation and policy, with an emphasis on backgrounds in health equity or health technology.  

The panel identified three key opportunities to improve quality in telehealth care, all centered around the prioritization of patient-focused services:   

The participants identified challenges to delivering optimal telehealth care, including:  

  • Privacy and data-sharing concerns
  • Lack of flexibility in delivery modalities that enable broad use of telehealth by all patients, families and caregivers 
  • Insufficient technical capabilities to promote culturally appropriate language translation 
  • Lack of tools and resources to relieve socioeconomic barriers to telehealth use and access
  • Lack of tools and resources to facilitate telehealth access by those with learning, intellectual, physical and cognitive disabilities
  • Lack of broadband access
  • Antiquated federal legislation and regulations 
  • Restrictive reimbursement and coverage policies 
  • Restrictive and disparate state licensure laws
  • Disjointed technology interface solutions that place a burden on patients and clinical teams  

“Although some patients and providers have benefited from telehealth, there are opportunities to improve its access and use to promote health equity and quality of care,” said the white paper authors.  

“Ease-of-use design principles, expanding broadband infrastructure, streamlining medical licensure to support interstate practice and sufficient reimbursement of telehealth services (payment parity) are essential approaches that maximize benefits and help realize the full potential of telehealth and related digital tools,” they continued.  


Even as major retailers such as Amazon and Walmart have invested big in telehealth expansion, advocates and some legislators have warned that virtual care access may remain fragmented.  

This past month, the American Medical Association released a report outlining key steps toward equity in the telehealth landscape.  

“To realize telehealth’s full potential, the AMA believes that those developing and implementing telehealth solutions must prioritize partnerships with historically marginalized and minoritized populations to ensure that solutions are designed to be accessible and work well for all,” said the organization in an issue brief.  


“We really have to change the way we think about health in this country. We have to put the patient at the center – not the doctors, not the insurers, not the policymakers, or anybody’s particular self-interest,” said Dr. Regina Benjamin, former surgeon general of the United States and founder and CEO of Bayou La Batre Rural Health Clinic, who participated in the NCQA roundtable.   

“Putting the patient first in our policy thinking is really where we can change healthcare and make more healthy communities,” Benjamin continued.  

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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