Telehealth, the delivery of healthcare services through digital communication technologies, expanded rapidly during the public health emergency due to temporary regulatory waivers. Now that these measures have ended, the long-term role of remote services is uncertain. Telehealth’s permanence hinges on three factors: stable regulatory policies, sustainable financial models, and continued integration by patients and providers.
The Post-Pandemic Regulatory Landscape
The widespread adoption of telehealth was facilitated by the temporary suspension of restrictive pre-pandemic rules. The transition from these temporary waivers to a permanent legal framework is creating a complex patchwork of state and federal regulations for providers.
State Licensure
The largest remaining hurdle is state-level licensure, which traditionally requires providers to hold a license in the state where the patient is physically located. Although many states temporarily loosened these rules for cross-state practice during the emergency, those waivers have largely expired. This return to strict state-by-state licensing limits the ability of providers to offer care across state lines, restricting the geographic reach of telehealth platforms.
Prescribing Controlled Substances
The ability to prescribe controlled substances via a virtual visit is another area facing regulatory scrutiny. Before the pandemic, the Ryan Haight Act mandated an in-person evaluation before a practitioner could prescribe certain medications remotely. The Drug Enforcement Agency (DEA) temporarily suspended this requirement but is now developing new rules for a special registration process to govern tele-prescribing. The DEA extended the waiver for the in-person examination requirement through the end of 2024 to allow time to finalize this new framework.
Securing Financial Viability
The economic sustainability of telehealth depends on whether payers, including government programs and private insurers, continue to reimburse virtual visits comparably to in-person services. During the emergency, many payers implemented “payment parity,” paying the same rate for virtual and in-person consultations. Without legislative mandates, private insurers often reimburse telehealth at lower rates, threatening the financial incentive for providers to offer virtual services.
The Centers for Medicare and Medicaid Services (CMS) sets precedents for the industry, and its reimbursement decisions are closely watched. While CMS has made some pandemic-era flexibilities permanent, such as covering mental health services via audio-only communication, other coverage rules remain temporary. Many states have varying laws regarding “service parity,” requiring coverage via telehealth if covered in-person, but fewer mandate “payment parity.”
A shift toward value-based care models offers a more stable foundation for telehealth reimbursement than simple payment parity mandates. These models pay providers for patient outcomes and overall efficiency rather than for each individual service performed. Telehealth is well-suited for this framework because it can reduce costs by preventing unnecessary hospital visits and improving chronic disease management.
Patient and Provider Integration
The continued success of telehealth relies on its acceptance and effective use by patients and healthcare professionals. Although utilization has declined from its pandemic peak, it remains significantly higher than pre-pandemic levels, demonstrating persistent demand.
Telehealth has proven indispensable in behavioral health, including mental health and substance use disorder treatment, where utilization is notably high. For patients, virtual appointments offer increased convenience, reduced travel time, and easier access to specialists, especially in rural or underserved areas. Providers generally report high satisfaction with the safety and effectiveness of telehealth, with studies showing similar patient outcomes for virtual and in-person care.
However, widespread adoption must confront issues of digital equity to ensure all populations benefit. Groups such as older adults, low-income individuals, and people of color are more likely to face barriers related to technology access, affordable high-speed internet, and digital literacy. Since a notable portion of Medicare beneficiaries lack access to a computer or smartphone, audio-only telephone visits are a necessary option for equitable access that must be supported by permanent coverage policies.
The Hybrid Future of Care
The evolution of telehealth is leading to its permanent integration as a complementary mode of care, not its disappearance. As regulations stabilize and financial models adapt to support value-based outcomes, the practice will move past its emergency status. The future of healthcare is increasingly a hybrid model, blending virtual and in-person care to maximize patient convenience and clinical effectiveness. This integrated approach ensures telehealth remains a core component of modern healthcare delivery.