For some employers, telemedicine is living up to potential. Is Yours?

cell_and_scope.jpgAs someone in the benefits industry, you didn’t need the Wall Street Journal article to tell you telemedicine is transforming health care. But you might also know that, unfortunately for the vast majority of employers who have telemedicine, it hasn’t delivered results.

Electronic communication has revolutionized industries—when was the last time you saw a bank teller?—and now it is transforming healthcare through telemedicine. According to the Willis Towers Watson 2016 Emerging Trends in Health Care Survey, more than 67% of employers with more than 1,000 employees will have a telemedicine benefit in place in 2016, and that level is expected to rise to 90% by 2018.

But like most things, all solutions are not created equal. What telemedicine benefit are you recommending to your clients and how is it addressing the big issues highlighted by WSJ?

THE DIRTY LITTLE SECRET IN TELEMEDICINE

While the article points out the many benefits of electronically connecting patients and doctors and how effective virtual care can be, the article (and most telemedicine companies) failed to mention that the usage rate of people accessing a doctor virtually is horribly low.

Most people are surprised to learn that while many people have access to a telemedicine service today, utility is near zero. Usage is measured by the utilization rate, or the number of consultations performed per 1,000 primary members. For telemedicine embedded in a major medical plan, that rate is below 1% (meaning fewer than 10 consultations per 1,000 members). For most employer-provided plans, the average is significantly higher at the still dismal rate of 7%.

Utilization is low due to a confluence of factors involving education, awareness, ease of use, and cost to the potential patient. What the industry averages illustrate is that most telemedicine providers’ interests are not aligned with their customers—which is to drive savings and convenience from diverted in-person physician visits.

Changing behavior requires a consistent communication strategy that is customized to the demographics and unique characteristics of each client's population. Many telemedicine companies were founded by insurance executives who actually hope to avoid usage because it increases costs. First Stop Health believes that telemedicine should drive value for our clients and their employees. As a result, First Stop Health drives the highest utilization rate in the industry, with an average of 44%, or more than six times higher than the industry average.

High utilization drives significant savings, which flows directly to the bottom lines of the company and households we serve. We are so confident that we will drive significant savings for our clients that we contractually guarantee we will save more money in diverted visits than the benefit costs, or we will refund the difference. First Stop Health offers the only savings guarantee in the industry.

DO PATIENTS TRADE QUALITY FOR CONVENIENCE?

As a majority of large employers rush to offer a telemedicine benefit this year, are they really putting their employees at risk for misdiagnosis? Or a better question is, “How is a telemedicine provider ensuring appropriate clinical quality in their physician encounters?” What is the quality assurance process for clinical and service quality?

At First Stop Health, we take clinical and service quality very seriously. Our doctor to member ratio is 1:1,000 ensuring that our physicians can service our members in less than five minutes. We review 100% of our calls (the industry as a whole only reviews about 10% of consultations) for service quality and patient outcomes and we actively ensure all of our physicians are completing consultations using the most up-to-date clinical data.  

DOES TELEMEDICINE UNDERMINE THE CONTINUITY OF CARE?

Most patients today can’t even see their doctor when they are sick because the average wait time to see a primary care doctor is 19 days. As a result, patients visit drugstore clinics or urgent care centers for treatment of non-emergency conditions like upper respiratory infections, allergies, flu, sore throat, pink eye, ear aches, or other infections that can also be treated effectively via telemedicine.

These clinics are primarily independent and not connected to the patient’s primary care physician’s health system, so the records are not transferrable. If an illness becomes chronic, patients should be directed to their primary care physician. With First Stop Health, a patient can print, email or fax their patient record to their primary care physician, which is not an option for patients who visit an urgent care center.  

WHO PAYS FOR THE SERVICE?

Telemedicine is one of the few benefits that genuinely keeps money in the pockets of employers and their employees. With the right telemedicine solution, who pays is less important than aligning incentives so that the benefit drives a positive return on investment. For example, the WSJ article highlights that major carriers have embedded telemedicine solutions in their health plans, which employees are hit with a co-pay to use. But this model doesn’t align incentives to drive value for the stakeholder paying the bill—employers. Embedding telemedicine in a health plan drives negative value for employers — about $500K of additional cost, actually.

For employers, healthcare expenses are often the second biggest budgetary item after payroll. More and more employers are opting to self-insure rather than pay ever-increasing premiums for full coverage. On the employee side, high deductible health plans are driving employees to be more careful about how they access healthcare.

First Stop Health aligns our value proposition with the incentives of the employer and employees to reduce cost and increase access. As we have discussed in previous updates telemedicine saves employers money, with the example of a company of 1,000 employees should expect to save more than $100,000 in the first year of implementing the benefitdriven from two sources:

  1. Avoided doctor visit fees. A company of this size should be able to prevent more than 350 ER, Urgent Care and doctor’s office visits every year.
  2. Productivity ROI. Keeping employees healthy and in the office means they are able to do their jobs more efficiently. By offering telemedicine, a company should expect to save their employees more than 700 hours a year by using telemedicine instead of visiting a physician when they are sick.

HOW PATIENTS FEEL

The article illustrates that a poll of adults found that 61% of consumers are open to using virtual healthcare services, but only 16% have done so. Of those who are willing to use them or have already done so, the top benefit reported is the convenience this healthcare delivery service creates for them, followed closely by the potential cost savings. What is behind those numbers, however, is the perception consumers have that healthcare is inconvenient and expensive.

At First Stop Health we have taken a different approach from most healthcare services in the market, flipping the historical healthcare paradigm upside down in order to transform everyone’s healthcare experience.

Accessing care should be easy and affordable. With First Stop, patients will be talking to a U.S.-based, licensed physician in less than 5 minutes for diagnosis and treatment, including a prescription, with no copay. For the employer, we guarantee that savings generated from avoided healthcare claims will exceed the cost of the benefit or we will refund the difference.

It doesn’t get much more convenient or affordable than that.