Common Spirit Mountain Region

Gerard Frunzi

The COVID-19 pandemic triggered a surge in telehealth adoption across the United States, followed by a period of stabilization. Healthcare providers, ranging from expansive hospital networks to independent practices, rapidly adapted to virtual care models to maintain patient access. While the specific implementation and utilization of telehealth programs now vary considerably among these organizations, several common themes are emerging across the industry.  

Reflecting on the past decade in telehealth, the service is returning to its foundational roots. This involves supporting new, clinically integrated strategies driven by incremental, targeted successes. It also means recasting the larger organizational strategy to align with ongoing strategic initiatives. These efforts require grassroots initiatives, hands-on support and a robust change management process. The goal is to minimize failures and provide immediate support when technical issues inevitably arise. 

Many healthcare organizations are exploring telehealth to address cost pressures while expanding their service offerings. This often involves careful evaluation of vendor contracts, which frequently include opportunities for cross-selling and expanding services beyond the initial scope. This strategy, aimed at fostering long-term partnerships, is not new but remains effective. Furthermore, many organizations are now recognizing the need for dedicated leadership to manage and integrate their diverse telehealth programs strategically. 

Many systems closely monitor the legal environment, delaying investment decisions while the federal government extends flexibilities for short periods. The background is that during the initial shift to telehealth, the federal government’s public health emergency order supported this shift in several critical ways. When COVID-19 first emerged, the public health emergency: waived geographic restrictions, allowing telehealth to the home for Medicare patients; allowed more sites, such as Federally Qualified Health Centers (FQHCs), to participate in telehealth; expanded the range of clinical services that could be delivered via telehealth; broadened technology options, prioritizing connecting with patients over rigorous contracting; provided providers with flexibility to practice across state lines; and offered cost-sharing waivers for some programs, covering copays and deductibles. Initially, these flexibilities were extended for six months or less, leaving telehealth leaders uncertain as expiration dates approached. Most extensions were granted just days before, or even on the expiration date. In 2025, the flexibility has been reduced to waiving geographic restrictions, expanding services, enabling FQHCs and Rural Health Clinics to provide care and continuing the delay of in-person mental health visit requirements. For the first time since 2020, people with high-deductible plans receive bills for their deductibles, as there is no longer a first-dollar rule covering telehealth services. The remaining flexibilities are extended to the end of September 2025, aligning with the government’s fiscal year. Understandably, organizations are hesitant to invest in something that may not be reimbursed and could face sustainability issues in the near term. 

“Telehealth's growth in the U.S. is driven by evolving technology stacks, strategic vendor partnerships and AI, but the industry needs long-term government support for sustainable, widespread implementation.” 

A significant opportunity exists within the vendor market. The technology stacks offered by both established and emerging healthcare vendors are increasingly robust. Market offerings from product and service vendors demonstrate a thoughtful approach to addressing industry needs. I have personally observed that the vendor market has made traditional go-to-market strategies, focused on delivering products effectively, a core competency. This execution support empowers healthcare organizations to achieve targeted, measurable outcomes more efficiently than ever by leveraging strategic vendor partnerships. This collaborative approach allows for a more focused and impactful telehealth implementation, ultimately benefiting providers and patients. 

Artificial Intelligence (AI) presents numerous opportunities to impact the telehealth industry significantly. Organizations are still determining how to best leverage AI's potential, often through small pilot programs. AI is currently in its proving ground in healthcare. We are past the sales pitch and now in the "show-me" phase of AI's application in healthcare. There are countless avenues for potential improvement using AI. The larger categories of AI use in healthcare generally include: saving time in documentation, improving communication for comprehensive evaluation and follow-up and developing AI as a care tool. Telehealth AI use cases also fall into these three categories. Improving the store-and-forward e-visit process is a promising area for initial success. I believe the new acronyms and AI product suites that will define how most healthcare is delivered in 10 years are yet to be created, but we can be assured they are on the horizon. 

To answer the question of what is next for telehealth in the United States, we first need long-term solutions enacted by Congress. Organizations planning for the future during these challenging financial times face barriers to committing to telehealth without assurance that it is a covered care route. New project initiatives leveraging vendor tech stack offerings will bring about comprehensive innovations. These will be accomplished through partnerships with Information Technology departments, which will be a key success factor as projects become more complex. Expect AI to deliver reliable, measured outcomes and advances in healthcare offerings. The vendor market will continue to grow and evolve as companies refine their product mix, targeting rural, small, independent clinics and large, expansive systems. 

In general, it continues to be an exciting time in telehealth!