At the December 14, 2017, open commission meeting of the Federal Communications Commission (FCC), commissioners will vote on whether to repeal current net neutrality rules. Such action may have wide-reaching impacts on the use of telehealth. Community health clinics, such as federally qualified health centers (FQHCs) and rural health centers (RHCs), could see higher rates for connectivity that may reduce, eliminate, or discourage them from using telehealth to deliver health care services, especially in rural areas. Additionally, telehealth in the home could be severely curtailed as consumers may face higher prices for connectivity that would be sufficient for a telehealth interaction.
Removal of net neutrality rules could negatively impact several other pieces of telehealth policy that have gained traction in recent months at the federal level. The Department of Veterans Affairs has shown increasing interest in using telehealth regardless of where the provider and patient are located. This has been signaled by House passage of HR 2123, recent introduction in the Senate of the Veterans Community Care and Access Act of 2017, and proposed regulatory changes in the program.
To allow practitioners and patients to provide and access care anywhere would require reliable and adequate connectivity that could be priced out of the users' range with removal of net neutrality. Certain policies within Medicare could also be adversely impacted, such as chronic care management, which allows for services to be in the home, as well as interest shown by the Center for Medicare and Medicaid Services and Congress in using more remote patient monitoring services, especially in the treatment of chronic conditions.
Careful consideration would need to be made regarding the future of net neutrality to avoid unintended consequences of depriving patients of care and inhibiting the use of telehealth. While potential policy could be created to protect health institutions such as FQHCs and RHCs from high rates, it would be more difficult to craft such a policy for a person who may receive services in the home.