Five Years Later: How Telehealth Transformed Access to Healthcare Post-COVID-19
March 11, 2025 marks the five-year anniversary of the declaration of the COVID-19 pandemic. The COVID-19 pandemic, declared by the World Health Organization in March 2020, radically reshaped the healthcare landscape, accelerating the adoption of telehealth and digital health services. As we mark the five-year anniversary of the pandemic's declaration, it is critical to reflect on how telehealth has evolved, how policy and legislation have supported its growth, and the instrumental role that CTeL has played in shaping telehealth policy and guidance.
The COVID-19 pandemic catalyzed healthcare's most significant transformation in decades. As we mark the fifth anniversary of worldwide lockdowns, the integration of telehealth into mainstream healthcare delivery stands as perhaps the most enduring change to emerge from the crisis.
This evolution didn't happen overnight. Telehealth's roots stretch back decades, but its widespread adoption required a perfect storm of technological readiness, regulatory flexibility, and urgent necessity. When in-person care became limited in March 2020, virtual options rapidly shifted from a convenient alternative to an essential lifeline.
Telehealth’s Pivotal Role During the Pandemic
At the onset of the pandemic, telehealth swiftly emerged as a lifeline for patients and providers. With hospitals overwhelmed and social distancing mandates in place, virtual care facilitated continued access to health services. From primary care visits to mental health consultations, telehealth utilization surged. According to a 2021 study published by FAIR Health, telehealth utilization increased by over 3,800% in the early months of the pandemic (FAIR Health, 2021).
According to a 2021 study published by FAIR Health, telehealth utilization increased by over 3,800% in the early months of the pandemic (FAIR Health, 2021).
Before 2020, telehealth existed primarily on healthcare's periphery. The technology had been developing since the 1950s, when a few hospital systems experimented with closed-circuit television links. By the early 2000s, rural health programs had begun implementing more sophisticated telehealth systems to address provider shortages in remote areas (Bashshur et al., 2016).
Despite these advances, regulatory barriers, reimbursement challenges, and technological limitations prevented widespread adoption. Medicare's telehealth coverage remained severely restricted, with patients required to be at designated facilities and within specific geographic areas to qualify for coverage (Centers for Medicare & Medicaid Services, 2019).
According to a 2019 survey by the American Hospital Association, only 76% of U.S. hospitals connected with patients through video or other technology, with utilization rates remaining low even among those with telehealth capabilities (American Hospital Association, 2019).
CTeL played a pivotal role in providing guidance to health systems, providers, and policymakers, ensuring patients had access to quality care regardless of physical limitations or geographic location. As questions emerged about regulatory compliance, reimbursement policies, and cross-state licensing, CTeL provided actionable insights to navigate the rapidly shifting telehealth landscape.
Critical Legislative Actions That Advanced Telehealth
The rapid expansion of telehealth utilization necessitated prompt and strategic legislative action. The federal government moved quickly to pass critical legislation aimed at ensuring widespread access to virtual care. Some of the most impactful legislative actions include:
The CARES Act (2020) – The Coronavirus Aid, Relief, and Economic Security Act was a pivotal piece of legislation that expanded Medicare coverage for telehealth services, waived certain Health Insurance Portability and Accountability Act (HIPAA) penalties for noncompliance, and enabled federally qualified health centers (FQHCs) to provide virtual care (Centers for Medicare & Medicaid Services [CMS], 2020).
The Consolidated Appropriations Act (2021) – Extended many telehealth flexibilities, including the ability for patients to access mental health services without in-person requirements and reimbursement for remote patient monitoring (RPM) (American Telemedicine Association [ATA], 2021).
The Consolidated Appropriations Act of 2023 – Ensured that key telehealth flexibilities would be extended through the end of 2024, particularly for Medicare beneficiaries, allowing telehealth to remain a core service (CMS, 2023).
Hospital at Home Programs – Recognizing the immense strain on hospitals during the pandemic, CMS expanded the Acute Hospital Care at Home initiative, allowing hospitals to provide inpatient-level care in a patient's home through remote monitoring and virtual care services. This program has demonstrated significant cost savings and reduced hospital readmissions (CMS, 2022).
The SUPPORT for Patients and Communities Act (2023) – A major leap forward for mental health services, this legislation mandated that telehealth services for behavioral health remain permanently reimbursed by Medicare, ensuring ongoing access to virtual mental health care (Congressional Research Service, 2023).
State-Level Telehealth Legislation – Across all 50 states, individual legislation evolved to either remove or expand barriers to telehealth, with some states permanently eliminating in-person visit requirements and expanding cross-state licensing, providing patients broader access to care (National Conference of State Legislatures, 2023).
The Current Landscape
Five years after the pandemic began, telehealth has settled into a “stable” position within the healthcare ecosystem. While utilization has decreased from peak pandemic levels, it remains dramatically higher than pre-2020 baselines. According to the McKinsey COVID-19 Consumer Survey, approximately 22% of all outpatient visits now occur virtually, compared to less than 1% before the pandemic (McKinsey & Company, 2023).
According to the McKinsey COVID-19 Consumer Survey, approximately 22% of all outpatient visits now occur virtually, compared to less than 1% before the pandemic (McKinsey & Company, 2023).
The mode of delivery has evolved as well. Purpose-built telehealth platforms have largely replaced the stopgap solutions implemented during the crisis. Integration with electronic health records, remote monitoring devices, and artificial intelligence now enhances virtual care capabilities.
Mental healthcare has seen particularly strong telehealth adoption, with over 60% of psychiatric services now delivered virtually according to a 2023 survey by the American Psychiatric Association (American Psychiatric Association, 2023). Studies show equivalent or better outcomes for telepsychiatry compared to in-person care, with significantly lower no-show rates (Yellowlees et al., 2022).
Rural healthcare has been transformed as well. The expansion of broadband infrastructure—accelerated by pandemic-era funding—has enabled more sophisticated telehealth applications in previously underserved areas. According to the Rural Health Information Hub, specialist access has dramatically improved, with rural patients now able to consult with urban medical centers without extensive travel (Rural Health Information Hub, 2024).
The Role of AI and Digital Health Innovation in Telehealth
One of the most promising developments in telehealth over the past five years has been the integration of artificial intelligence (AI) into healthcare delivery. AI-driven diagnostic tools, virtual nursing assistants, and remote patient monitoring (RPM) platforms are fundamentally changing the standard of care.
For example, generative AI in virtual care settings is being used to augment diagnosis, streamline clinical documentation, and enhance patient engagement. According to a report by McKinsey & Company (2023), AI in healthcare is expected to generate annual savings of over $360 billion by reducing administrative burdens, increasing diagnostic accuracy, and improving patient outcomes.
According to a report by McKinsey & Company (2023), AI in healthcare is expected to generate annual savings of over $360 billion by reducing administrative burdens, increasing diagnostic accuracy, and improving patient outcomes.
Additionally, virtual-only healthcare startups such as Ria Health, Teal, and Behaivior AI have redefined healthcare delivery, enabling patients to access care without traditional in-person appointments. These companies have not only improved access to care but have also demonstrated significant cost savings. Research from the American Hospital Association (2023) shows that virtual-first care models reduce healthcare costs by up to 30% while improving patient satisfaction.
Persistent Challenges
Despite tremendous progress, significant challenges remain. The digital divide continues to limit telehealth access for some populations. A 2023 survey by the Pew Research Center found that 24% of Americans in rural areas and 13% in urban areas still lack reliable broadband access, creating a potential new healthcare disparity (Pew Research Center, 2023).
Payment models also remain in flux. While most insurers cover telehealth services, reimbursement rates vary widely. Some services receive payment parity with in-person care, while others face significant discounts, creating financial disincentives for providers (CTeL, 2023).
Licensure restrictions, though eased in many states, still create complications for nationwide telehealth programs. The Interstate Medical Licensure Compact now includes 38 states, but complete standardization remains elusive (Federation of State Medical Boards, 2024).
CTeL remains at the forefront of telehealth policy research, advocating for regulatory frameworks that protect access to care while promoting the adoption of innovative solutions like AI, RPM, and virtual-first care models. Our ongoing work with Congress, state legislatures, and regulatory agencies ensures that telehealth remains a viable, equitable, and scalable model for delivering healthcare.
The Need to Evolve Without Overregulation
As telehealth continues to advance, there remains a critical need to balance innovation with appropriate regulation. Overregulation threatens to stifle the rapid momentum telehealth has achieved, while under-regulation could compromise patient safety. Policymakers must continue to strike a balance that enables innovation while ensuring patient protection and quality care.
As telehealth enters its post-pandemic maturity, several trends are emerging. Hybrid care models—combining virtual and in-person services—are becoming standard for many conditions. Remote patient monitoring, which connects providers to patients' health data between visits, is growing rapidly.
The Road Ahead
Five years after COVID-19 forced healthcare's hand, telehealth has proven its value beyond crisis response. By expanding access, improving convenience, and often delivering comparable clinical outcomes, virtual care has earned its place in modern healthcare delivery.
The pandemic may have initiated telehealth's rapid rise, but its staying power stems from something more fundamental: it solved real problems for both patients and providers. As technology continues advancing and policy frameworks mature, telehealth's role will likely expand further, becoming an even more seamless part of how healthcare is experienced and delivered.
The transformation hasn't been perfect, and significant work remains to ensure equitable access and appropriate utilization. But telehealth's journey from emergency solution to essential service represents one of the pandemic's most significant and positive legacies for healthcare.
As we reflect on the past five years, it is evident that telehealth has transformed the healthcare ecosystem, and its potential is far from fully realized. Policymakers, healthcare leaders, and innovators must continue collaborating to address access, equity, and affordability challenges. CTeL will remain a steadfast advocate in ensuring that telehealth continues to expand without unnecessary regulatory barriers — ultimately improving patient outcomes and reshaping healthcare delivery.
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