Telemedicine's

TELEMEDICINE’S Tipping Point Written by Bruce Shuntan Virtual visits seen as growing part of more aggressive employee engagement strategies for self- funded health plans Some medical visionaries, entrepreneurs and researchers believe the future of health care delivery is telemedicine, also known as telehealth, while skeptics label virtual visits between patients and providers impractical for certain cases and a threat to quality of care. Concern also has been expressed about traditionally low utilization of this service. 4 The Self-Insurer | www.sipconline.net TELEMEDICS TIPPING POINT | FEATURE Whatever the case may be, there’s little doubt about the format appearinG especially to 59% in 2016 from just 30% the previous palatable across the self-insured community. year, accordinG to Mercer’s National Survey of Employer-Sponsored Health Plans. A chief advantaGe of telemedicine for self-funded employers is savinGs and the potential to improve productivity and employee satisfaction because of the service’s consumer-friendly In addition, 90% of 133 larGe U.S. employers nature, according to Mike King, chief sales offcer of Teladoc, a pioneer in this feld known as surveyed by the National Business Group the nation’s leading provider of telehealth services with 7,000 clients. on Health reported that they will make telemedicine available to employees in states “When employees use the service and don’t have to leave work to have a consultation, the where it is allowed in 2017. That represents employer isn’t losinG that employee for several hours while they make the round-trip to a a sharp increase from the current 70%. By visit,” he explains. “We often hear from beneft managers this is the one beneft that they put 2020, the nonproft group predicted that in that they actually Get thank-you notes from their employees, who are just amazed that a “virtually all larGe employer respondents will service even exists that they actually can Get care 24/7 from home or work or whenever offer telemedicine,” while utilization also is they need it.” expected to increase steadily. Another advantage is that self-funded health plans brand their own telemedicine benefts The rise of telemedicine is seen as part of a for a more personalized touch, whereas fully insured plans communicate throuGh health larGer health care consumerism movement insurance carriers. “When we produce a welcome kit, for example, it’s GoinG to have the whose multiple movinG parts present employer’s brand on that kit,” King explains. challenGes for health plan manaGement. A telemedicine call typically is $40 compared In the self-insured model, there’s a willinGness to Get more involved in ensurinG that with $125 for a traditional offce visit. telemedicine companies enGaGe their employee population, adds Adrian Davis, CEO of MYidealDOCTOR, a venture-backed mHealth company that seeks to blend technoloGy Fueled by star power with top-notch physicians. “Self-funded Groups obviously have the capacity to structure those benefts in a way that incentivizes their employees to use the service,” he says. Some high-profle names are now associated with the telemedicine feld. One of the Rising to new heights nation’s leading pop psychologists, Dr. Phil McGraw, co-founded a telemedicine The U.S. telemedicine market is expected to reach $4.5 billion by 2018 – an eye-popping gain from $440.6 million in 2013, notes a recent study by business information provider HIS. In addition, a recent Harris Poll found that 64% of the 2,019 U.S. adults it surveyed are willinG to have doctor visits via video. Employers are warminG up to the concept, which could save them more than $6 billion a year in health care cost, according to a Towers Watson analysis. Industry observers say the trend clearly has reached a tippinG point where it behooves self-insured employers to consider addinG this option to their health plan, but also ensure that the beneft is being used by enough people. Telemedicine is on track to becominG a mainstream employee health beneft. For example, these service offerinGs amonG 2,544 larGe employers polled surGed January 2017 | The Self-Insurer 5 Guardian® in Stop Loss sync When evaluating stop loss carriers, just look at the numbers. Looking for assurance that Guardian Stop Loss Insurance will protect you against catastrophic claims and higher than expected medical plan usage? 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Guardian’s Stop Loss Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Financial information concerning The Guardian Life Insurance Company of America as of December 31, 2015 on a statutory basis: Admitted Assets = $48.1 Billion; Liabilities = $42.0 Billion (including $37.0 Billion of Reserves); and Surplus = $6.1 Billion. Policy Form #GP-1-SL-13. File # 2016-21397 Exp. 8/17 TELEMEDICS TIPPING POINT | FEATURE company with his son, Jay McGraw, who’s “Yet that is a common A key sellinG point of telemedicine is that also executive producer of the talk show practice for many 24/7 it can help keep patients from focking “The Doctors.” health-care services.” to emerGency rooms, which obviously is where there’s a propensity for skyrocketing Their Doctor on Demand website describes Be that as it may, the American Telemedicine costs. Having the beneft in place allows the widespread lack of access to health care Association predicted that its foot soldiers self-insured employers to increase their ER providers as “a massive, growing problem” would Generate 1.25 million visits by the co-pay because it makes access to care easy in the U.S. It touts 24/7 video visits on end of 2016. Teladoc, nation’s leading and accessible, which KinG describes as “an smartphone or computers as an antidote to provider of telehealth services with 7,000 extra lever around cost savinGs beyond just long wait times that mar primary care visits, clients, surpassed a key milestone this past the savings the beneft is going to drive.” If which could take two to three hours from November with a record-settinG101,600 awareness and utilization of these services is start to fnish, and 25 days on average just to monthly patient visits. Consults hit a daily hiGh enouGh, then he says it’s even easier to see a psychiatrist or psychologist. hiGh of 4,158, while 425 patient consults justify plan design changes. durinG the month’s busiest hour translated Another key player in the industry is John The expansion of telemedicine services into a visit every 8.5 seconds. The surGe Sculley, former CEO of Pepsi-Cola and or applications may be limited only by a was attributed to member-enGaGement Apple Computer who serves as vice carrier’s imaGination. For example, Teladoc initiatives, alonG with access to abroad chairman of MDLIVE. He once suGGested recently launched a unique feature that network of more than 3,100 board-certifed, that rather than rely on a political solution allows a three-way video consultation with state-licensed physicians and behavioral to health care challenGes, the best approach an employee careGiver, aGinG parent and a health specialists and expansion into clinical in the U.S. is to empower consumers with physician who is based near that relative. specialties. tools such as telemedicine that place control DermatoloGy and behavioral health also in the hands of patients. These numbers come at a time when the represent areas of growth for telemedicine, Despite the operational effciencies that Centers for Disease Control and Prevention which can have a far-reachinG impact on the telemedicine brinGs to a time-challenGed reported total fu visits in 2016 to be below latter. the national baseline, which suGGests the society, critics question whether the lower “If you think about behavioral health, there trend is gaining traction and acceptance. prices come with hidden costs. To wit: a is a stiGma to GoinG, especially in smaller chance that virtual visits could undermine Consult commonality towns,” KinG says. “For some individuals, there quality and the sanctity of doctor-patient is still a sense of discomfort with the thouGht relations. Moreover, concern is mounting Medical conditions that are commonly of beinG recoGnized when seekinG behavioral about virtually prescribinG antibiotics for treated virtually include anythinG from health, and that can be avoided while ailments that traditionally rely on lab tests or bronchitis, rashes, pinkeye and urinary tract patients confdently receive the services physical exams for a defnitive diagnosis. infections. A GrowinG number of Teladoc they need via telehealth.” And with much of members are uploadinG up to three photos “Most physicians would behavioral health beinG a cash-paid business for physicians to review ahead of their with hiGher rates than treatinG physical never accept a phone call “visualized” consultation.

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