Think back to pre-pandemic times, when telemedicine—although used increasingly in recent years—was perhaps still widely considered a “very nice to have" and not necessarily a “need to have." It’s amazing how things have changed in the last four months, since the COVID-19 pandemic began.

BCBSRI very quickly made the decision in mid-March, even before Governor Raimondo mandated it, to provide coverage for telemedicine services by all in-network providers at 100% of the in-person fee schedule, with no cost sharing.Download now Telemedicine visits surged 50% in March, and now virtual healthcare interactions are on pace to top one billion in 2020, according to Forrester Research.

So, what does the future hold for telemedicine?

Obviously, nobody knows for certain what will happen with COVID-19, and if there is going to be a “second wave" in the fall, as some have predicted. In many respects, we’re still dealing with the “first wave." But one thing is for certain: telemedicine is absolutely a major part of the future of medicine. And while its use may slow down a bit from current unprecedented levels, it’s certainly not going anywhere.

Before COVID-19, telemedicine use was much more prevalent for behavioral and urgent care situations, and heavily focused in rural areas or areas with limited access to healthcare. But as COVID-19 started to spread, and patients needed ways to receive healthcare safely, its use increased exponentially. Aiding that usage—besides health insurers like BCBSRI covering the service—were relaxed restrictions to access, expanded Medicare fee-for-service coverage (virtual services for Medicare beneficiaries alone were up almost 12,000% in March and April), and reimbursement for audio-only visits.

It’s clear that our healthcare system has changed drastically almost overnight. Hospitals and primary/specialty care practices have made significant investments in telemedicine technology to be able to support the increased use, which will certainly continue. The rate and speed of patient adoption of telemedicine tells us that its advantages and convenience are too great to ignore. However, many of the regulatory changes that have helped that adoption may only last the duration of the public health crisis (again, there’s no way of knowing how long that will be), although many are calling for some or all of them to remain in place.

So where does that leave us? Which pieces of the telemedicine puzzle will and should remain in “normal" times? There are numerous considerations…financial, socioeconomic, governmental, technological, and even political. Another important point, and shift with telemedicine, is that we are treating so many “new" conditions/symptoms over video now, and more types of providers are using it than ever before. We really don’t yet know telemedicine’s effectiveness for so many of those things we’re treating with it, and it remains to be seen if it can ultimately be as effective as face-to-face care.

Certainly these are difficult questions to answer, and those answers won’t come overnight. The pandemic has created an unparalleled shift in medicine, and telemedicine is a major part of it.

This is a conversation that’s only just beginning, and we look forward to having this discussion with you, our participating providers, in the weeks and months ahead. And again, thank you for everything you continue to do to keep Rhode Islanders safe and healthy.