The Michigan House of Representatives recently passed several straightforward reforms that would increase access to health care providers and services across the state and promote price transparency in hospital services.
Traditionally, health professionals treated patients almost exclusively in person. The COVID-19 pandemic changed that. Telehealth use exploded as regulations preventing its full value were suspended. Michiganders embraced the opportunity, which allowed them more convenient access to and choices of health professionals, both in Michigan and from other states.
Acknowledging the success of this policy, the House passed legislation to make it permanent. Seeing health professionals in other states isn’t new or controversial. Michiganders do it all the time. They just have to travel there in person. Seeing those same professionals through telehealth is currently prohibited, however. The House is looking to change that by allowing licensed providers from other states to see willing Michigan patients through online or mobile platforms. State lines don’t halt the spread of diseases or prevent illnesses; they shouldn’t restrict access to physical and mental health professionals.
Because the education, training, scope-of-practice, and licensing requirements for health professionals across the country are largely standardized, it is safe for Michigan to allow professionals who are licensed elsewhere to treat residents who want their services. Increased access to telehealth professionals increases choices, reduces costs, travel, and wait times, and assists with possible language and cultural barriers to seeking care.
Adding access to health professionals won’t just help address physical illnesses. It also helps with added access to mental health professionals. The aftermath of school and economic shutdowns remains to be fully seen, but it will likely include more mental health challenges. Removing a barrier to mental health access will help Michigan come out of the pandemic even stronger.
A second telehealth bill reduces the costs of using contact lenses by allowing contact wearers to renew their lens prescriptions with a licensed optometrist or ophthalmologist online or through a mobile platform. Thirty-eight states, including Indiana, Ohio, Illinois, Wisconsin and Minnesota, allow such renewals.
The standard of care for the virtual exam must be the same as it is for in-person exams, and it can only confirm that the current prescription still works for a patient. Any changes to the eyes requiring a new prescription would require an in-person comprehensive exam. Online prescription renewals for contact lenses save consumers time and money. They could also lead to reduced spending on government employee eye care services and government health care benefits, saving taxpayers money.
Another lesson learned from the pandemic relates to the scope-of-practice restrictions placed on various health care professionals, which prevent them from practicing to the full extent of their education, training and work experience. These government-initiated restrictions were suspended early on during the COVID-9 pandemic to address provider shortages. Because the suspension was successful and safely done during an emergency, lawmakers should make it permanent.
One such scope-of-practice bill improves access to anesthesia and analgesic services by fully recognizing the services provided by certified registered nurse anesthetists. CRNAs enter the workforce with a master’s or doctoral degree. They must have a minimum of seven to eight years of education, training, and experience before they can become a licensed CRNA.
The bill does not mandate that hospital inpatient or outpatient facilities, freestanding surgical outpatient facilities, physicians, podiatrists, or dentists change their current policies. It simply acknowledges that CRNAs provide the safe selection, ordering, prescribing, and administration of anesthesia and pain-relieving agents and can provide them independently of a physician. Numerous studies confirm that anesthesia care provided by independent CRNA providers is safe. Increasing access to their services will give providers and patients more choices without harming health outcomes, especially in rural and other underserved areas of Michigan.
Making hospital prices transparent is another important change to help consumers become better shoppers of health care services. Pricing, a critical component of the free market, is almost entirely missing within the health care industry. Without pricing, competition — a mechanism to help lower prices and increase quality — is limited or nonexistent.
Consumers benefit by knowing ahead of time the total cost of hospital procedures that can be scheduled in advance. While consumers typically don’t pay the full price due to insurance coverage, they can save money on their out-of-pocket costs by choosing less costly facilities and providers. A bill recently passed in the Michigan House brings more transparency to health care costs by requiring hospitals to begin posting the prices of about 300 shoppable services and procedures. A federal rule requiring the same became effective on Jan. 1. But because federal regulations can change, putting these federal regulations into Michigan law further encourages hospitals, insurance companies, and entrepreneurs to create consumer tools that make this information more digestible.
As health care costs rise year after year, the four reforms mentioned here will increase access to much-needed health professionals and encourage more competition, giving customers a better value for their dollar.
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