The COVID-19 pandemic has required health care practices to rapidly adopt a variety of telehealth capabilities to continue providing care and access to providers while keeping workers and patients safe from the virus. These capabilities include phone and video visits, eConsults, text messaging, and more.

Much of this has been possible because the federal government and California, in response to the pandemic, took unprecedented action to loosen restrictions and expand coverage and payment for telehealth services. It is unclear, however, how long these changes will last. Despite enormous progress, much more must be done to ensure that the benefits of telehealth reach populations with low incomes throughout California and to ensure lasting improvements in access to care.

In May 2020, CHCF approved over $6 million to help California reach a tipping point for telehealth in the safety net. This marks CHCF’s single largest investment in close to 15 years of work focused on telehealth.

This page provides an overview of CHCF’s Tipping Point for Telehealth Initiative and its key partners. Updates on partners, progress, and lessons learned, as well as other resources, will be added over time.

Goals

Through this initiative, CHCF seeks to speed the following outcomes:

• Medi-Cal enrollees statewide have access to care via telehealth, including those who currently face digital and other barriers to using telehealth.
• Safety-net providers throughout the state learn and adopt best practices in providing care via telehealth.
• California policymakers adopt coverage and payment policies to ensure that Medi-Cal enrollees’ access to care via telehealth endures after the COVID-19 crisis has ended.

Activities

Advance Policies and Lasting Payment Changes

CHCF is supporting the Center for Connected Health Policy and the California Telehealth Policy Coalition to advance lasting changes in telehealth coverage and payment policies to increase access to care via telehealth.

Education, Technical Assistance, and Funding to Implement Telehealth

• CHCF is supporting the California Primary Care Association, California Medical Association, and E-Consult Workgroup to develop and disseminate educational tools and resources for health centers and physician practices that are core to California’s health care safety net. Resources to be provided include information-sharing webinars, toolkits on best practices, and support to assist safety-net providers make technology and integration decisions.
• CHCF has launched the Connected Care Accelerator to support safety-net practices as they build their telehealth capabilities. CHCF is funding an Innovation Learning Collaborative managed by the Center for Care Innovations. Twenty-three safety-net organizations delivering primary care (including mental health) through telehealth will participate. Supported with grant funding and technical assistance, they will surface ongoing challenges, test and share solutions, and lay the groundwork for lasting change. (Additional grant funding for the learning collaborative has been provided by the Blue Shield of California Foundation and L.A. Care.) CHCF is also providing funding to 30 safety-net providers to start or scale up telehealth capabilities through an Infrastructure and Spread track within the Connected Care Accelerator. Grant recipients selected in July 2020 are listed on the Center for Care Innovations website.

Monitoring and Evaluation

CHCF is also investing in evaluating and learning from the experience of safety-net providers and their patients with telehealth. Still a work in progress, evaluation partners include RAND, which will examine use of telehealth by patients served by organizations in the Connected Care Accelerator and the experiences of providers. A separate statewide CHCF-sponsored survey of Californians in households with low incomes will examine patient experiences and identify any barriers that prevented patients from accessing telehealth services.

If you have questions about the Tipping Point for Telehealth Initiative, contact Chris Perrone, CHCF’s director of Improving Access. Learn more about other CHCF telehealth projects in areas such as behavioral health.