Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Marie VanderKooi, DNP, MSN, RN-BC

Second Advisor

Dr. Joy Turner Washburn, EdD, RN, WHNP-BC

Third Advisor

Carol Baker, MSN, RN

Academic Year



Purpose: At the onset of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) granted flexibility for audio-only visits. However, CMS indicated possible cessation of reimbursement for audio-only telehealth when the pandemic ends. This project explored current audio-only telehealth reimbursement and proposed post-pandemic policies for Medicaid beneficiaries at the state level and the perceived benefits and challenges from the perspective of rural providers.

Methods: Data was collected from a rural ambulatory clinic that included patients ≥ 18 who received telehealth during the study period (April 2020 - May 2021). The providers at this clinic were surveyed on the experience and usability of audio-only telehealth. These results were reported using chi-square statistics and p values. Finally, ten purposively selected states were analyzed for their telehealth policies and legislation throughout the pandemic.

Findings: There were 5,024 telehealth visits conducted during the data collection with 47% being audio-only. Survey results were not statistically significant, however, themes regarding audio-only telehealth barriers emerged indicating a lack of reimbursement, inability to perform a physical exam, and technology limitations. The state policy analysis showed that nine out of ten states had proposed bills to continue reimbursing for audio-only telehealth. Most states planned to reimburse for all care, provided it can be performed the same as in-person care.

Conclusions: The results of this project gave insight into the usefulness of audio-only telehealth after the pandemic. This study identifies strategies that can be used to inform policy-makers regarding the continuation of audio-only telehealth reimbursement.

Available for download on Saturday, August 03, 2024

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