Medicare seems to be proceeding cautiously with telemedicine. Traditional Medicare reimburses healthcare providers for 37 services in specific circumstances when they are delivered using telemedicine, which is defined by the Medicare Learning Network as “an interactive audio and video telecommunications system that permits real-time communication between you … and the beneficiary.” These services range from consultations to education and training sessions to psychotherapy and smoking cessation programs.
Employer groups, on the other hand, are embracing telehealth benefits. Typical telehealth services are accessible 24/7 via smart phone, tablet, computer, or telephone. A recent article in CFO Magazine discusses the results of the latest Mercer National Survey of Employer-Sponsored Health Plans. Here are the highlights:
- Nearly 60% of employers offered telehealth benefits in 2016. Nearly four times as many as (16%) offered them in 2014 and double the percentage (30%) that offered them in 2015.
- Three-quarters of employers that offer telehealth share in the cost of each visit by offering plans with visit copays of $25 vs. the retail cost of a telehealth visit of $40.
- More than one-quarter (28%) of large employers that offer telehealth also offer cost transparency tools to help employees make cost-effective choices.
This strong interest in telehealth is another method to help employees better manage their healthcare costs. As more and more workers (29% in 2016 vs. 25% in 2015) have high-deductible health plans, they are looking for lower-cost alternatives to access care.
Retail Clinics and Telehealth Services Stretch Networks
Narrow networks are more common each year. Members report longer appointment wait times in HMO networks and other networks that have gatekeepers. And in open access narrow networks there are fewer available providers requiring many members to change doctors when they first join the plan and change again as doctors move in and out of the networks.
Employee Benefit News (registration required) noted that “82% of respondents [to the Mercer survey] cover visits to a retail clinic as another lower-cost and convenient option for their health plan members. Such a visit typically costs about $60 before the annual deductible is met.” With lower costs and convenient hours, many people find that these clinics, like telehealth services, are a good option to supplement plans with narrow networks.
Telehealth services also enable faster communication with a primary care doctor, shorter wait times, and no travel time when compared to an ER or urgent care center visit.
Has telehealth become a viable substitute for in-office care for your members? How are you using telehealth services to expand your network?