policies likely would keep telehealth utilization relatively low but target those most in need with precision. Alternatively, the goal could be to set financial incentives to ensure that every patient can access high-quality telehealth services not only from their regular providers, all of whom offer hybrid care models (a mix of telehealth and in-person services) but also from providers in distant communities and established telehealth companies. To work toward this goal, payers could (1) eliminate geographic and originating-site restrictions, (2) reimburse video telehealth at the same rate as in-person services to encourage universal adoption by clinicians, (3) eliminate reimbursement for audio-only telehealth because of quality concerns, (4) cover only select services shown to be equivalent in quality (e.g., behavioral health services, communication with patients with chronic illnesses), and (5) require an occasional inperson visit to offset some of the limitations of telehealth. Policymakers will need to make many key decisions with little supporting evidence, but this is not unique to telehealth policy. No matter how the policy environment evolves, it is unlikely that telehealth advocates will get everything they are hoping for. As one stakeholder stated during the November 2020 meeting of the Medicare Payment Advisory Commission, “We will have to throw out some of the good [that telehealth offers] to protect ourselves against some of the bad” (Medicare Payment Advisory Commission, 2020). Among the myriad of potential policy goals is the desire to retain as much of the good as possible. In the case of telehealth, there is a lot of good, both in the midst of a public health emergency and beyond. 13 References Abir, Mahshid, Christopher Nelson, Edward W. Chan, Hamad AlIbrahim, Christina Cutter, Karishma Patel, and Andy Bogart, Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States, Santa Monica, Calif.: RAND Corporation, RR-A164-1, 2020. As of December 23, 2020: https://www.rand.org/pubs/research_reports/RRA164-1.html Adams, Susie M., Michael J. Rice, Sara L. Jones, Edward Herzog, Lauri John Mackenzie, and Leslie G. Oleck, “TeleMental Health: Standards, Reimbursement, and Interstate Practice,” Journal of the American Psychiatric Nurses Association, Vol. 24, No. 4, 2018, pp. 295– 305. Ashwood, J. Scott, Ateev Mehrotra, David Cowling, and Lori UscherPines, “Direct-to-Consumer Telehealth May Increase Access to Care but Does Not Decrease Spending,” Health Affairs, Vol. 36, No. 3, March 2017, pp. 485–491. Carroll, Aaron, “The ‘Iron Triangle’ of Health Care: Access, Cost, and Quality,” JAMA Forum, blog post, October 3, 2012. CBO—See Congressional Budget Office. Centers for Medicare & Medicaid Services, “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers,” December 1, 2020. Congressional Budget Office, “Cost Estimate: At a Glance: H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019,” September 30, 2019. Dunham, Charles C., IV, and Matthew Sprankle, “The SUPPORT for Patients and Communities Act: Expanding Medicare Coverage of Telehealth Services to Combat the Opioid Crisis,” National Law Review, blog post, November 6, 2018. As of December 23, 2020: https://www.natlawreview.com/article/support-patients-andcommunities-act-expanding-medicare-coverage-telehealth-services Eze, Nkiruka D., Céu Mateus, and Tiago Cravo Oliveira Hashiguchi, “Telemedicine in the OECD: An Umbrella Review of Clinical and Cost-Effectiveness, Patient Experience and Implementation,” PLoS One, Vol. 15, No. 8, August 13, 2020. Halpren-Ruder, Daniel, Anna Marie Chang, Judd E. Hollander, and Anuj Shah, “Quality Assurance in Telehealth: Adherence to EvidenceBased Indicators,” Telemedicine and E-Health, Vol. 25, No. 7, July 11, 2019, pp. 599–603. Health Resources and Services Administration, “Policy Changes During COVID-19,” webpage, last updated December 17, 2020. As of December 23, 2020: -19-public-health-emergency/ Hoffman, Laura C., “Shedding Light on Telemedicine and Online Prescribing: The Need to Balance Access to Health Care and Quality of Care,” American Journal of Law and Medicine, Vol. 46, No. 2–3, 2020, pp. 237–251. Medicare Payment Advisory Commission, “Public Meeting, Monday, November 9, 2020,” proceeding notes, November 9, 2020. Mehrotra, Ateev, “Expanding the Use of Telehealth: Promise and Potential Pitfalls,” testimony presented before the House Energy and Commerce Committee, Subcommittee on Health on May 1, 2014, Santa Monica, Calif.: RAND Corporation, CT-409, 2014. As of December 23, 2020: https://www.rand.org/pubs/testimonies/CT409.html Mehrotra, Ateev, Michael Chernew, David Linetsky, Hilary Hatch, David Cutler, and Eric C. Schneider A Qualitative Study of Primary Care Physicians’ Experiences With Telemedicine During COVID-19 Teresita Gomez, MD, Yohualli B. Anaya, MD, MPH, Kevin J. Shih, PhD, and Derjung M. Tarn, MD, PhD Background: Primary care practices rapidly adopted telemedicine visits because of the COVID-19 pandemic, but information on physician perspectives about these visits is lacking. Methods: Fifteen semistructured interviews with practicing primary care physicians and physiciansin-training from a Southern