Telehealth in 2026: How CHCs Can Protect Preventive Care Access Without Adding New Infrastructure

In a lot of community health centers, the patients who most need follow-up are the least able to come back in person. The visit went well, the plan made sense, and then life happened. Work schedules. A broken car. A kid home sick. An address that changed again.

Telehealth is one of the few tools CHCs can use to keep that care from slipping through the cracks. Not because video visits exist, but because a phone call that actually happens can be the difference between controlled blood pressure and another year of drift.

The hard part in 2026 is not whether telehealth is useful. It is whether it stays predictable enough to build around, and whether clinics can make it work for patients who are most likely to be left out.

Telehealth is already part of the CHC preventive care footprint

The job is enormous. Health Resources and Services Administration reports that in 2024, more than 32.4 million people received care at HRSA-funded health centers, and about 90% had incomes at or below 200% of the federal poverty level. Those centers delivered 139.4 million visits that year.

The clinical workload behind preventive care is just as big. In 2024, health centers cared for about 5.9 million patients with hypertension and 3.36 million with diabetes, and as we previously shared, the overweight and obesity rate is over 75%.

Telehealth is already woven into that reality. National Association of Community Health Centers reports that 98% of CHCs offer telehealth, and that telehealth enabled 18.4 million CHC visits in 2024. More than a third of those visits involved behavioral health needs, which tells you something important about what patients will actually show up for when access barriers are real.

The 2026 issue is policy churn, not one deadline

Many teams are tracking January 30, 2026 for Medicare telehealth flexibilities, and for good reason. Medicare summarizes it plainly. Through January 30, 2026, beneficiaries can receive telehealth from anywhere, including home. Starting January 31, 2026, most services revert to rural and facility-based requirements. Many teams are tracking January 30, 2026 for Medicare telehealth flexibilities, and for good reason. Some carve-outs remain available beyond that date. These include mental and behavioral health care in the home, certain acute stroke services, and monthly ESRD home dialysis visits.

Centers for Medicare & Medicaid Services echoes the general rule in its CY 2026 telehealth FAQ. The broad, non-behavioral flexibilities are available through January 30, 2026, and then generally revert on January 31. Meanwhile, the U.S. Department of Health & Human Services highlights what is more durable. That includes permanent home-based telehealth for behavioral and mental health and permanent audio-only options in Medicare behavioral health scenarios.

The new 2026 detail is that the deadline is now entangled with federal budget negotiations. A major funding package, H.R. 7148, passed the House on January 22, 2026 and passed the Senate on January 30, 2026 with amendments. That means final enactment steps still matter for what becomes operationally true week to week. Independent summaries of the package describe it as including a roughly two-year extension of Medicare telehealth flexibilities through December 31, 2027.

The operational problem is the cycle this creates. A time-limited extension protects access, but it also forces another round of scheduling, staffing, billing, and patient communication planning the next time the clock resets. We saw this dynamic in 2025, when flexibilities briefly lapsed and later returned with retroactive payment guidance, leaving clinics to manage uncertainty in real time.

A practical stance for CHC leaders is to assume variability and design for it.

• Keep behavioral health telehealth strong. It is on firmer footing in Medicare than many other services, including permanent home-based access and the ability to use audio-only in certain behavioral health contexts.

• Build a back-up path for primary care follow-ups. Create a workflow that can shift a home-based telehealth follow-up into either an in-clinic visit or an eligible facility-based telehealth touchpoint without rebuilding templates, staffing models, or patient instructions each time the rules change.

Use telehealth where it closes preventive care loops

Telehealth helps when it targets the drop-off points that drive missed care. You do not need a new program to do that. You need a short list of use cases where the same ten minutes, done reliably, prevents months of drift.

Hypertension and diabetes follow-ups

These are often short visits that fall apart because the barrier is not clinical complexity. It is getting back in the building. With 5.9 million patients with hypertension and 3.36 million with diabetes in the HRSA-funded system, follow-up reliability is the metric.

Telehealth works well for results review, medication adherence barrier checks, home blood pressure review, and quick course-corrections before the next in-person visit.

Behavioral health touchpoints that keep people engaged

HRSA reports that health centers provided mental health services to about 3.0 million patients in 2024, and screened more than 74% of teen and adult patients for depression.  That is not a side service line. It is part of preventive care.

Telehealth can carry brief therapy, check-ins after a positive screen, and medication management between in-person visits, especially when stigma or transportation keeps patients away.

Screening and vaccine prep that turns into completion

Telehealth cannot perform a mammogram or a colorectal screening, but it can do the work that makes completion more likely. HRSA reports nearly 2.0 million breast cancer screenings, 4.4 million cervical cancer screenings, and 3.6 million colorectal cancer screenings in 2024.

A short telehealth visit can confirm preferences, address fears, order the right test, and schedule the in-person service visit that closes the loop.

No-show risk management

Telehealth is not magic, but it does tend to show up differently in missed-visit data. A large safety-net study of over 2.6 million scheduled outpatient encounters found telehealth visits were associated with a 29% reduction in the chance of no-show after adjustment.  At Luro Health we’re seeing similarly low rates of no-shows for telehealth visits, with some cohorts of patients at <5% no show rates.

That is not just convenience. It is continuity.

Make telehealth team-based so it does not become provider doing everything

Telehealth gets fragile when every task lands inside the clinician visit. CHCs do better when the work is shared across the team, with clear handoffs between team members

A simple model that fits into existing staffing that we have seen work internall is;

Before the visit

A care coordinator does a short check-in that confirms:

• Preferred language and interpreter needs
• Phone number and back-up number
• Patient location and privacy
• Medication list, basic vitals if available, and the one or two top care gaps to address

During the visit

The PCP or advanced practice provider focuses on decisions and a plan:

• What can be handled remotely today
• What needs an in-person service visit and when
• Who follows up, and by what channel

After the visit

This is where CHCs win or lose preventive care:

• Pharmacy checks access barriers and adherence, then closes the loop with the clinician if changes are needed
• Nutrition support and health coaching are used as follow-through for diabetes, blood pressure, and weight-related goals, not as a separate program
• Care coordination schedules the care and determines how the patient can get to their appointment
• Confirmation the test was completed

This is how telehealth supports preventive care without building new infrastructure. It is the same team, just using different touchpoints.

Do not let telehealth break your UDS and quality measure logic

A common trap is doing good care over telehealth and losing the credit for it.

Health Resources and Services Administration publishes a crosswalk on how telehealth services should be considered in 2024 UDS clinical quality measure reporting. It spells out where telehealth can count for denominator eligibility, how telephone evaluation and management rules vary by measure, and how numerator completion can be verified outside a visit for some measures.

Two operational takeaways are worth making concrete in your clinic:

• For some measures, telehealth helps the numerator because you can document that the service happened during the measurement period, even if it happened somewhere else.

• Denominator rules are not uniform. You need a short internal cheat sheet for the handful of measures you actively manage so front desk, rooming staff, and clinicians are not guessing.

Equity and cultural competence callout

From our experience, telehealth can reduce transportation barriers, but it can widen gaps if it assumes broadband, English fluency, and high health literacy. Pew Research Center reports that while 80% of U.S. adults subscribe to home broadband, only 57% of adults with household incomes under $30,000 do. About 15% of adults are smartphone-dependent, and that rises to 28% among those under $30,000.

Center for Health Care Strategies notes that older adults, people of color, low-income individuals, and people with disabilities are more likely to face barriers to telehealth, and that modality choices like video versus audio-only shape who can actually use care.

In practice, that means designing for virtual visits from day one, building interpreter workflows into scheduling, and using community health workers or care coordinators to help patients prepare in their preferred language.

Wrap-up

Telehealth in2026 is less about technology and more about reliability. If your telehealth touchpoints help patients complete screenings, show up for follow-ups, and stay connected to behavioral health support, you are protecting preventive care access in the places where it is easiest to lose.

The work is not building something new. It is making the care you already provide easier to keep.

Sources

• National Association of Community Health Centers. Telehealth and CHCs: January 2026 (Jan 2026). CHC telehealth adoption and 2024 telehealth visit volume, including behavioral health share.

• Health Resources and Services Administration. Impact of the Health Center Program (last reviewed Aug 2025, 2024 data). Patient volume, income mix, visit volume, screening and chronic disease performance context.

• Health Resources and Services Administration. 2024 UDS National Data, Table 6A: Selected Diagnoses and Services Rendered (2024 reporting year). Counts of patients with hypertension, diabetes, and overweight/obesity in health centers.

• Centers for Medicare & Medicaid Services. Telehealth FAQ Calendar Year 2026 (updated Nov 14, 2025). Medicare telehealth timing and rule changes after Jan 30, 2026.

• U.S. Department of Health & Human Services. Telehealth policy updates (updated Nov 21, 2025). Summary of Medicare telehealth flexibilities and permanent behavioral health provisions.

• Medicare. Telehealth Insurance Coverage (accessed Jan 2026). Patient-facing description of what changes after Jan 30, 2026, and key exceptions.

• Health Resources and Services Administration. Telehealth Impact on 2024 UDS Clinical Quality Measure Reporting (last updated July 1, 2024). Practical crosswalk for denominator and numerator logic when care is delivered via telehealth.

• Pew Research Center. Americans’ Use of Mobile Technology and Home Broadband (Jan 31, 2024). Broadband and smartphone-dependence statistics that matter for telehealth design.

• National Association of Community Health Centers. Assessing Patient Satisfaction with Health Center Telehealth Services (Jul 2023). Patient satisfaction and perceived access benefits of telehealth in health centers.

• Center for Health Care Strategies. Telehealth’s Impact on Health Equity (Apr 2024). Equity isks and modality considerations for safety-net telehealth programs.

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