Telehealth services have become an integral part of many medical groups — no longer just a pandemic necessity, but a permanent feature. However, uncertainty around reimbursement and future regulations has kept many healthcare leaders from fully committing to long-term telemedicine strategies.
A July 22, 2025, MGMA Stat poll offers new insight: 45% of medical group leaders report their telehealth volumes this year are the same (28%) or higher (17%) than the same period in 2024, while 39% noted they are lower. Another 3% were unsure, and 13% noted they did not offer telehealth. The poll had 270 responses.
When including only practices that do offer telehealth, 52% reported steady (32%) or growing (20%) volume, compared to 44% who saw a decline this year and 4% who were unsure.
By the end of 2023, telehealth utilization had stabilized, with 12.7% of traditional Medicare beneficiaries using virtual services. Importantly, today’s fluctuations in telehealth volume are more likely a result of market segmentation — driven by patient preferences, specialty-specific needs, and geographic influences — than a simple return to pre-pandemic care models. As such, rather than viewing declines in certain areas as a drop in overall demand, practices should focus on expanding telehealth where it offers clear benefits.
The policy front for telehealth
Fears of the so-called “telehealth cliff” — the expiration of pandemic-era telehealth waivers in September 2025 — have eased with the Centers for Medicare & Medicaid Services (CMS) 2026 Medicare Physician Fee Schedule (MPFS) proposed rule. If finalized, the rule would offer several measures to boost the long-term viability of virtual care, including:
- Streamlining the process for adding new telehealth services
- Expanding access to virtual supervision
- Removing frequency limits for telehealth services in inpatient and nursing home settings.
MGMA members can watch the on-demand version of the recent 2025 Washington Policy Mid-Year Update webinar with insights from MGMA Government Affairs. MGMA members also enjoy exclusive access to our analysis of the proposed 2026 MPFS rule.
However, healthcare organizations should still prepare for the expiration of the temporary DEA flexibilities around controlled substances. Uncertainty surrounding the forthcoming special-registration rule will require careful planning. Furthermore, state-level telehealth policies remain inconsistent: While 44 states and the District of Columbia have laws requiring private payer coverage, payment parity is only mandated in about half of states. Practices must tailor strategies to align with the regulatory and reimbursement differences across states.
- Read MGMA’s recent advocacy letter on a DEA telehealth extension.
Navigating telehealth challenges
A primary challenge for telehealth remains payment risk. To mitigate this, healthcare leaders should ensure a diversified payer mix, negotiate telehealth service minimums into commercial contracts, and budget conservatively using low-range reimbursement scenarios for 2026, with potential upward adjustment once CMS regulations are finalized.
Ongoing regulatory uncertainty also demands planning. Leaders should develop standardized credentialing workflows for the DEA special registration process and maintain flexible workflows Additional obstacles include navigating state licensure complexities, bridging the digital divide through community partnerships, and addressing telehealth-related workflow inefficiencies — such as technology fatigue — that can lead to provider burnout.
Strategic value of telehealth
Telehealth offers significant strategic value, especially in the preservation and optimization of appointment capacity and the reduction of no-show rates. Telehealth also can support better performance in risk-based contracts, such as the Medicare Shared Savings Program (MSSP), Medicare Advantage (MA) plans, and commercial accountable care organizations (ACOs) — boosting quality metrics and lowering costs. Additionally, telehealth:
- Offers powerful opportunities for workforce optimization, enabling advanced practice providers (APPs) to work to the top of their licenses through virtual direct supervision models as proposed by CMS, increasing clinical efficiency and operational flexibility.
- Builds patient loyalty and can prevent care leakage to retail or virtual-first competitors.
- Leads to richer data sets, which can be leveraged for remote patient monitoring (RPM) and remote therapeutic monitoring (RTM), laying the groundwork for predictive analytics and digital therapeutics.
Tracking telehealth success: Key metrics
To ensure successful telehealth integration, practices should closely track:
- Visit modality mix: Balance between virtual and in-person visits should reflect strategic goals of each specialty.
- No-show rates: Compare rates across visit types to understand patient behavior.
- Contribution margin per visit: Factor in technology costs and staffing to assess financial stability.
- Quality outcomes: Track condition-specific outcomes (e.g., blood pressure control, diabetes management, and readmission rates — between virtual and in-person cohorts.
- Patient satisfaction: Use Net Promoter Scores (NPS) to gauge digital care experiences.
Specialty-specific telehealth strategies
Primary care telehealth
Primary care providers (PCPs) are well-positioned to use telehealth for chronic disease management. Using RPM, especially through new short-duration codes (2-15 days), offers practices the chance to improve quality metrics and ratings, such as HEDIS and MA Star scores. Virtual group visits for conditions such as obesity and diabetes are gaining traction, and CMS has proposed permanent coverage.
Immediate actions: Set telehealth targets for hybrid visit models, pilot the Medicare Diabetes Prevention Program (MDPP), and/or address the digital divide through community-benefit funding for broadband access. Tele-triage also can help reduce unnecessary emergency department visits.
Surgical specialties
Telehealth for surgical practices can help reduce day-of-surgery cancellations and improve patient satisfaction through post-operative care. Virtual preoperative assessments and wound checks, combined with RPM, can reduce readmission rates and provide new revenue streams. However, skepticism remains around virtual physical exams, and malpractice insurance may not fully cover telehealth.
Solutions: Standardize tele-preop protocols, pilot post-surgical RPM (especially in orthopedics), secure telehealth-specific malpractice coverage, and document visits via video when appropriate.
Nonsurgical specialty telehealth
Specialties like cardiology, endocrinology, neurology, and behavioral health benefit from consistent virtual patient engagement. For example, continuous glucose monitoring (CGM) in endocrinology benefits from telehealth, and behavioral health can address workforce shortages by offering audio-only sessions, now permanently reimbursed by Medicare. However, nonsurgical specialties need to manage risks such as changes in controlled substance prescribing. A strategic focus on virtual chronic-care clinics, enhanced by AI-driven analytics to filter actionable RPM data, will be critical for success.
Strategies: Prepare for controlled substance prescribing changes, build virtual chronic care clinics, and leverage AI tools to sift actionable insights from RPM data.
Multispecialty groups
Multispecialty practices and integrated health systems benefit from delivering a uniform patient experience. Shared investments in AI and digital therapeutics can improve care and align with new CMS reimbursement models. However, governance complexity and competing capital priorities persist.
Recommendations: Form a centralized virtual care steering committee, consolidate vendors, stay engaged with federal and state policy developments, and adopt modular investments — e.g., hardware leases or monthly software subscriptions — to stay flexible until CMS and DEA policies are finalized. Integrating telehealth into broader cybersecurity efforts is also critical for ensuring data security across virtual care platforms.
Conclusion
Telehealth is no longer an optional add-on but rather a strategic lever for access, margin preservation, and risk-contract success. With the regulatory framework slowly coalescing around permanent virtual care, practices must navigate the uncertainty of 2025 without losing momentum.
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