Health Policy on Providers and Consumers

Healthcare policy plays a pivotal role in shaping the healthcare landscape. These policies influence both the quality and accessibility of services provided to consumers while also impacting the operations and sustainability of healthcare providers (Toll et al., 2022). As lawmakers strive to improve healthcare through reforms, they must strike a delicate balance between the policies’ relevance to consumers and maintaining a viable healthcare system for providers. This essay explores recent local or state healthcare policies in Michigan and their impact on both consumers and providers.

Policy Identification and Summary

The healthcare policy of interest is HB-512, also known as ‘The Insurance Code of 1956’ signed on June 24, 2020. This bill is a significant piece of legislation that serves as the foundational law governing insurance regulations in the state of Michigan. The bill primarily focuses on the introduction of telemedicine and remote patient monitoring to cater to the needs of patients (State of Michigan, 2020). HB-512 is a legislation among the five package of bills signed by Michigan Governor Gretchen Whitmer in June 2020.

According to this legislation, those dealing with insurance shall not require face-to-face contact between the healthcare provider and the patient for services provided through telemedicine (State of Michigan, 2020). The legislation opposes the previous law that required insurers to cover patients for services delivered in real-time only. The legislation requires the expansion of telemedicine and the services must be provided by a healthcare professional who is licensed and registered in Michigan. To be considered telemedicine, the bill requires the provider to examine the patient via secure interactive audio, video, or both and through messaging services.

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One of the strengths of the bill is its establishment of a comprehensive regulatory framework for the insurance industry. The bill covers what telemedicine entails, who will provide the services, and which platforms will be allowed to provide telehealth services. By providing a structured and detailed set of guidelines, the bill ensures that insurance companies operate within clear boundaries, promoting fairness, transparency, and accountability in the insurance marketplace.

One weakness of the observed policy is that it deals with the evolving dynamics of health information technology. The industry is going through various changes and advancements in technology which may necessitate further amendments in the future. For example, the increasing recognition and approval of advanced practice nurses to practice independently may see insurers cover telehealth services offered by these individuals. Such changes may hinder the ability of the policy to adapt and respond effectively to changing market conditions and consumer needs.

Policy Impact on Consumer Stakeholders

The consumer stakeholders of this policy include patients who purchase insurance policies, employers who provide insurance coverage to employees, and advocacy groups. The bill has a positive impact on these consumers because it increases healthcare access for many. The policy allows providers to care for patients without requiring physical contact thus promoting healthcare access to those in remote areas (Toll et al., 2022). The policy also sets standardized coverage for consumers allowing individuals to decide how they want to receive care. One negative impact of this policy is that increases the cost of investing in technology and maintaining these technologies (Gajarawala & Pelkowski, 2021). Most patients may prefer to use both telemedicine and in-person visits to the provider leading to unnecessary cost increments.

Policy Impact on Provider Stakeholders

The provider stakeholders of this policy include the insurance companies, insurance agents, healthcare providers, and regulatory agencies. These providers must comply with the policy by providing telemedicine services to consumers and ensuring the services are covered by the relevant bodies (Toll et al., 2022). One of the positive impacts of the policy on providers is that it increases healthcare coverage in many areas. The regulation allows physicians and other authorized providers to care for patients from different locations without the need for in-person visits (Gajarawala & Pelkowski, 2021). Secondly, the policy promotes standardization of practices across healthcare institutions. It allows providers to utilize similar telehealth technologies to care for patients. Another key impact is the clarity and stability that comes with the regulation. The policy helps the providers and consumers to understand their obligations and it clarifies uncertainties associated with telehealth service delivery.

The passing of the telemedicine policy in Michigan poses certain challenges to consumers and providers. One issue that can be observed is compliance with regulatory laws and policies. For example, the utilization of telehealth services requires compliance with HIPAA laws and other regulations that protect patient information (Gajarawala & Pelkowski, 2021). Healthcare institutions will have to spend extra capital to ensure proper security measures are undertaken to ensure the safety of the patient. Another potential negative impact is that the fluctuating healthcare market conditions may lead to insurance pricing issues. For example, most patients may prefer to utilize telehealth services and this will increase insurance costs depending on the provider. Lastly, the policy exposes providers to legal and compliance risks. It increases risks of penalties and reputation damage if telehealth services are not delivered according to the required standards.

References

Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners : JNP, 17(2), 218–221.

https://doi.org/10.1016/j.nurpra.2020.09.013

Toll, K., Spark, L., Neo, B., Norman, R., Elliott, S., Wells, L., Nesbitt, J., Frean, I., & Robinson, S. (2022). Consumer preferences, experiences, and attitudes towards telehealth: Qualitative evidence from Australia. PloS One, 17(8), e0273935. https://doi.org/10.1371/journal.pone.0273935

State of Michigan. (2020). Gov. Whitmer Signs Bills Increasing Health Care Access Into Law.

https://www.michigan.gov/whitmer/news/press-releases/2020/06/24/gov-whitmer-signs-bills-increasing-health-care-access-into-law