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A brand new research revealed in JAMA Community Open finds that low Medicaid telehealth reimbursement in New York State could also be exacerbating a workforce disaster at Federally Certified Well being Facilities (FQHCs), significantly amongst psychological well being care practitioners. The problem compounds present monetary instability at FQHCs and limitations to telehealth entry amongst low-income New Yorkers who depend on safety-net care.
The research, led by researchers at Columbia College Mailman Faculty of Public Well being, highlights a number of attainable options, together with fee parity for telehealth companies, long-term funding for telehealth infrastructure, and assist for hybrid care fashions to satisfy numerous affected person wants.
“Telehealth has many advantages for patients and providers, but only if it’s supported by equitable and sustainable funding policies,” says first writer Thalia Porteny, Ph.D., assistant professor of Well being Coverage and Administration. “Our findings underscore the urgent need for Medicaid reimbursement reforms to address workforce shortages and ensure vulnerable populations can access the care they need.”
The researchers carried out 56 interviews with management, clinicians, and administrative workers at six FQHCs in all 5 boroughs of New York Metropolis. Individuals described telehealth experiences, together with components associated to workers turnover, affected person satisfaction, and monetary sustainability inside FQHCs.
Key findings
FQHCs reported dropping as much as 40% of their psychological well being workers resulting from insufficient reimbursement and lack of distant work choices, resulting in lengthy affected person waitlists and lowered entry to care.
Many sufferers face limitations to telehealth, together with lack of web entry and digital literacy, significantly amongst older adults and people with restricted English proficiency.
Present reimbursement insurance policies create disparities between FQHCs and different suppliers equivalent to hospitals, leaving FQHCs underfunded and unable to compete for workers or put money into telehealth infrastructure.
“In the face of potential Medicaid cuts and broader austerity measures, our study’s findings suggest that it would be detrimental to implement cost-cutting measures in telehealth reimbursements in community health centers in New York and more broadly,” says co-author Sorcha A. Brophy, Ph.D., assistant professor of Well being Coverage and Administration.
“Such budget cuts could exacerbate provider shortages, increase barriers to care for vulnerable populations, and ultimately lead to worse health outcomes. Consequently, this could further destabilize community health centers—a health care program that has long enjoyed bipartisan support.”
An accompanying editorial written by Isaac Dapkins of NYU Langone and NYU Grossman Faculty of Drugs praises the research. Dapkins serves as Chief Medical Officer of a big FQHC in Brooklyn and chair of the scientific committee for the Group Well being Middle Affiliation of New York.
“Porteny et al have presented an outstanding summary of the impact of Medicaid telehealth reimbursement changes. FQHCs have been a core pillar of access to care in the US for years and are a model primary care service delivery,” he writes.
The research was co-authored by Emily Burroughs, a former Columbia Mailman analysis affiliate.
Extra info:
Research: Thalia Porteny et al, Experiences of Telehealth Reimbursement Insurance policies in Federally Certified Well being Facilities, JAMA Community Open (2025). DOI: 10.1001/jamanetworkopen.2024.59554
Editorial: Isaac Dapkins, Telehealth and Federally Certified Well being Facilities—A Weak Future, JAMA Community Open (2025). DOI: 10.1001/jamanetworkopen.2024.59510
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Columbia College’s Mailman Faculty of Public Well being
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