Bill may cement telehealth coverage

A new bill passed by the House and Senate offers a more accessible version of healthcare through telehealth. That is, for those with access to the internet. 

During the height of the pandemic in New Hampshire, doctors’ appointments were forced online, prompting Gov. Chris Sununu to sign an executive order that required health insurance providers and Medicaid to cover telehealth the same way they cover in-person appointments. The bill would extend this coverage past the pandemic. 

However, healthcare providers who work with those in rural parts of the state are worried the bill might leave their patients behind. 

Less than half of households in rural areas of New Hampshire have access to high-speed broadband, which is necessary for video telehealth appointments, according to the most recent report from the Broadband Center of Excellence at the University of New Hampshire. 

Daisy Goodman, a nurse-midwife, provides care for pregnant women in rural areas of New Hampshire, the majority of whom cannot afford broadband internet or a data plan for their cellphones. During the pandemic, this lack of access has been further exacerbated since many of her patients who work in the service industry have lost their jobs. 

She said it’s imperative that her patients have access to quick answers to their questions, especially if they have a newborn or are pregnant. 

Goodman has developed creative ways of getting care to her patients while doctor’s offices have been closed— whether it be finding a place with internet the patients can drive to or getting permission to provide care via text message. 

While the bill’s definition of telehealth was expanded to include audio-only phone calls for those without access to fast internet, Goodman said most of her colleagues agree that phone calls are significantly less effective than a video call. 

She said there are some things that just can’t be done over a phone call, like showing a rash. 

“Video for everyone is what equitable care would look like,” she said. 

Goodman, who also acts as the director of Women’s Health Services at the Dartmouth-Hitchcock Perinatal Addiction Program, is piloting a program that subsidizes the cost of cellphone data and the internet with a small group of women. 

She recruited participants who said access to internet was causing them to miss telehealth appointments. If successful, the program could lead the way for a larger study, potentially with federal funding.