One Big Reason Why A Telemedicine Program Might Not Work

August 22, 2019

First Stop Health

Telemedicine can have real impact for employers and employees — if employees actually use it, that is.

But the truth of the matter is this: Today, most employers offer telemedicine within their employee benefit plan, but most employees never use .

What’s the problem?

There are several reasons why a telemedicine program fails. But if there’s one indicator that the program will fail, it’s this: using a telemedicine service that is embedded within an employer’s health plan.

In fact, according to a Mercer study, telemedicine use is twice as high for employers who use a specialty telemedicine provider (outside of the carrier) versus those who use telemedicine embedded within the . Telemedicine only provides value for an employer when employees use it instead of expensive options such as the ER or urgent care.

Still, the vast majority of employers use a carrier-embedded telemedicine option. Why? Inertia. 

It’s easy to stick with carrier-embedded telemedicine, as that’s the status-quo today and it appears in many cases that the benefit is “free” because the small cost is included in a health plan that is priced to cover that small cost but does not call it out. It’s not free.  Plus, there’s a misconception that adding a new telemedicine benefit is difficult and time-consuming, but it’s not.

Telemedicine isn’t carriers’ bread-and-butter service. Instead, it’s a nice perk for carriers to throw in the mix. As a result, telemedicine gets buried in a list of employee benefits and is not a priority.

Here’s why carrier-embedded telemedicine often fails.


Employee engagement is vital to ensuring employees actually know about and use telemedicine. But carriers typically do not produce much content or collateral to help engage employees. Instead, HR is left with the burden. As a result, only 19% of employers believe their employees understand their benefits. 

Instead, specialty telemedicine providers (those that operate outside of the health plan) are often more dedicated to employee success. These providers produce custom materials — such as emails, posters, postcards and flyers — to ensure employees know about telemedicine.


Telemedicine providers embedded within the carrier typically require users to pre-register for the service. But employees often don’t think about telemedicine until they are actually sick and need it.

Many “carved out” telemedicine providers remove this friction by eliminating pre-registration, creating a simpler, more convenient experience when needing to use it.


Most carrier-embedded telemedicine services charge a copayment or consultation fee per telemedicine visit with a doctor – usually equal to the copay of an in-person visit. 

No one likes to pay for a service they’ve never used before, if they are not sure they won’t have to pay another fee to go to the doctor’s office. Telemedicine services that are not part of carrier health plans often charge little to no consultation fee.  


Carriers profit from each claim, as they are paid, in part, based on the number and dollar amount of claims. They have no incentive to reduce the number and size of claims by encouraging telemedicine use, as doing so would hurt their bottom line.

Instead, carved-out telemedicine providers are often invested in employers’ success. Employers will not renew the service unless their employees value the convenience and cost savings and the employers see a return on investment.


As a result, carrier-embedded providers rarely produce any net savings for employers. If employees don’t know about telemedicine, they don’t use it and they go to the urgent care or ER for their medical needs. Telemedicine has zero to minimal value for these employers

Telemedicine providers that are outside of the insurance carrier can save employers money. Because these providers are invested in employers’ success, these companies can provide true ROI to the employers and employees and keep employees happy and healthy.

Before your next benefits renewal or strategy meeting, make sure you know your options and don’t be afraid to ask questions about your telemedicine plan. There are better ways than carrier-embedded telemedicine.


Originally published Aug 22, 2019 8:32:37 PM.