TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is how clinicians can take advantage of the telehealth flexibilities extension to 2027 by integrating telehealth and virtual care fully within their operational workflow and within patient care. The author, Matthew Order, is Vice President of Business Development at Yosi Health. He has more than 20 years of healthcare technology and SaaS experience including previous roles at MEDITECH, athenahealth and Buoy Health. At Yosi, he leads enterprise adoption across health systems, translating product integrations into measurable operational improvements for practices and patients.

The Centers for Medicare & Medicaid Services (CMS) recently extended many Medicare telehealth flexibilities through December 31, 2027. That policy decision signals what providers already know: telehealth is no longer a short-term option to expand access to care, but a permanent channel of care delivery.

That policy certainty is welcome, but it also exposes a hard truth: simply offering video visits won’t deliver value unless telehealth is embedded into the day-to-day operational workflows of the practice. Clinics that want telehealth to reduce cost, improve access, and protect revenue must redesign the patient journey so virtual care is predictable, reimbursable and measurable.

Here are the practical, operational steps clinics should take now.

Move pre-visit upstream

The biggest operational losses happen around patient visits, e.g. when intake is incomplete, insurance is unknown, or staff must chase missing information. One way to change this is by moving pre-visit work upstream: require or encourage patients to complete digital intake forms before an appointment and surface those discrete data fields directly into the chart. This isn’t just a patient convenience, it fundamentally changes how front-office work gets done. Studies show that centralizing reminders and automating pre-visit tasks improves appointment utilization and reduces no-shows, two levers that matter for telehealth ROI.

Treat eligibility as clinical infrastructure, not an afterthought

Nothing kills collections faster than an unpaid copay or an ineligible telehealth claim. Embed real-time eligibility and benefits checks into the pre-visit flow so patients see their financial responsibilities before the encounter and staff can resolve red flags ahead of time. Organizations that operationalize eligibility verification as a revenue-cycle control point report fewer denials and faster time-to-cash. This is the difference between telehealth being a marginal convenience and a reliable revenue stream.

Design rule-based automation for phone and scheduling channels

Studies show over 60% appointments are still made by phone. If your telehealth offering can’t integrate with phone volume and scheduling rules, it is difficult to scale. Deploy rule-based automation that reads live availability, applies clinic booking policies, verifies benefits, and either completes the booking or hands off with full context to a human. For transactional tasks, rule-based systems often outperform free-form AI systems because they reduce follow-ups, corrections, and operational risk.

Measure clinical and financial outcomes, not vanity metrics

Define a tight set of KPIs tied to margin and access: completed telehealth visit rate, no-show reduction, denial rate for telehealth claims, point-of-service collections, and staff minutes reclaimed per patient. A simple 60–90 day pilot with baseline and target thresholds will tell you whether integration and automation are working. And instrument technical reliability as well; API success rates, data mapping accuracy, and escalation quality matter just as much as outcomes.

Protect equity and patient experience as you scale

Telehealth should expand access, not create new disparities. Make digital intake mobile-first and low-bandwidth, provide multilingual options, and maintain assisted touchpoints (phone registration, in-clinic support) for patients who need them. Evaluate patient satisfaction specifically by channel; a good telehealth system should reduce friction, not shift it elsewhere.

Make governance non-negotiable

Without clear operational ownership, telehealth programs drift and performance deteriorates. Who owns booking rules? Who maintains payer mappings? What are clear escalation policies for clinical red flags? Assign cross-functional ownership (e.g. operations, revenue cycle, clinical leaders, and IT) and lock in a change-control cadence that prevents “rule drift” as policies and payer contracts change. Evidence that EHR workload-per-visit can rise even when visit volume falls illustrates why governance and workflow redesign must accompany modality shifts.

Pilot pragmatically—and scale what earns results

Don’t rip-and-replace overnight. Start with two tightly scoped pilots: for example, telehealth follow-ups for chronic care and virtual urgent visits for same-day access. Keep pilots time-boxed, assign a process owner, and require week-over-week reporting on the KPIs that impact margin and access. If real-time eligibility and pre-visit intake reduce denials and nursing callbacks in the pilot, scale; if not, iterate.

Why this matters now

Policy windows like CMS’s telehealth extension present a rare opportunity – but only practices that pair clinical intent with operational discipline will secure lasting gains. With continued Medicaid churn and administrative pressure on primary care, clinics can’t afford telehealth programs that add friction or unpredictability. Integrating intake, eligibility verification, automation, and governance turns telehealth into a reliable channel for expanding access and stabilizing revenue. Recent analyses from KFF highlight how enrollment volatility is already increasing administrative burden across care settings.

By operationalizing telehealth – moving work upstream, protecting revenue at intake, automating predictable tasks, and measuring what counts – clinics can shift from friction to flow. That’s the difference between telehealth that breaks even and telehealth that delivers sustainable access, better outcomes, and measurable financial returns.