COVID-19 pandemic, these programs can also be invaluable for disseminating emerging knowledge on a novel threat (Project Echo, undated). Public health emergencies, of course, do not always involve a pandemic; natural disasters, such as from weather events like hurricanes or wildfires, can also create localized health emergencies. Telehealth has long been considered a valuable tool to deploy in such situations. DTC telehealth companies can also leverage their established networks, tap into providers from unaffected areas to quickly mobilize response where local networks are disrupted, and help evolve their response as the situation changes (Uscher-Pines, Fischer, and Chari, 2016). 11 Some DTC telemedicine companies did step forward to offer free visits to those affected by Hurricanes Harvey and Irma in 2017. Researchers studied the more than 2,000 services provided to individuals by one company in the aftermath of these two hurricanes, two-thirds of which were provided to first-time telehealth users (Uscher-Pines et al., 2018). Visits spiked within the first few days of each of the hurricanes, but most visits concerned health issues unrelated to the damage directly caused by the hurricanes: ARIs, chronic conditions, and medication needs. Less than 10 percent of the visits were injuries, back problems, or joint issues that might have been caused by the hurricane itself or resulting recovery efforts. Although it might not make sense to regulate the use of telehealth services for the sole purpose of bolstering emergency preparedness, policymakers and providers could work together to come up with sets of temporary policies regarding telehealth to quickly enable its use in future public health emergencies. Increase the Provider Supply Telehealth offers numerous flexibilities for clinicians and could be deployed to increase the provider supply. This is especially important for specialties that are currently experiencing or expect to experience workforce shortages in coming years because of clinician retirement or increased demand for care. If telehealth can encourage existing providers to work more hours from home or encourage retired providers to return to practice, it can have a significant effect. For example, through the MAVEN Project and AccessDerm, retired or semiretired physicians have been paired with safety net clinics to offer services on a part-time volunteer basis (Uscher-Pines and Rudin, 2016; Uscher-Pines, Rudin, and Mehrotra, 2017). These programs appear to be a win-win for the physicians and the clinics alike: They address physician shortages in underserved communities and give physicians meaningful opportunities to continue practicing medicine. Recommendations Charting a way forward with telehealth policy after the end of the COVID-19 pandemic will not be easy. Policymakers are currently under pressure from advocates to retain the temporary policies that broadened access to telehealth services. However, provider interest in telehealth remains uncertain and heavily influenced by how the policy environment evolves. Many policymakers and payers are once again becoming interested in measures that would limit utilization and contain costs. Policymakers have numerous levers to expand telehealth access and, at the same time, control the resulting growth. Utilization-management techniques that are designed to reduce unnecessary care and control costs include reducing reimbursement for telehealth services as compared with in-person services, covering only certain services (e.g., where quality is proven and there is a need to increase utilization), narrowly defining telehealth (e.g., excluding audio-only visits from reimbursement), requiring preauthorization and other forms of gatekeeping, restricting who can initiate visits, limiting patient types (e.g., only permitting use of telehealth with established patients), imposing frequency limits (e.g., allowing patients to have only three telehealth visits per year), requiring in- 12 person visits in some frequency, and imposing greater costsharing for telehealth visits. In deciding which of these techniques to apply, policymakers first need to articulate the post-pandemic policy goals of telehealth. Given that policymakers operate at many different levels and across 50 states and territories, federal leadership to codify telehealth goals would be helpful to guide goal-setting and avoid the proliferation of incongruent or even contradictory policies. A common goal of telehealth policy in 2022 could be to increase access for only the most underserved, thereby also reducing disparities in utilization without significantly increasing costs overall. If this is the goal, payers could eliminate the geographic and originating-site requirements that make telehealth inconvenient for the underserved and also fail to acknowledge that underserved patients can live in any community; however, payers could choose to reimburse telehealth visits only for patients who have insurmountable barriers to accessing in-person services (e.g., no visits in the prior year, mobility challenges, no local provider within 50 miles). Furthermore, payers could continue to reimburse for audio-only visits because many underserved patients are not prepared for video visits, but only when there is a documented barrier to video visits (e.g., patient lives alone and does not have a device). These