More Insurers Pushing Virtual Care for Cost Savings

More and more insurers are expanding the use of telemedicine, just as a new study shows promising cost savings of up to 25% from virtual care when implemented properly.

The latest insurer to announce an expansion of its telemedicine offerings is UnitedHealthcare, which recently said it would eliminate out-of-pocket costs for its 24/7 Virtual Visits program for eligible members enrolled in fully insured employer-sponsored plans, starting July 1.

Besides making care more convenient and reducing costs for its enrollees, the insurer is hoping more access to virtual care will encourage earlier visits, which can reduce the risk of complications or need for emergency care later on.

Other insurers have also been working with their network providers to increase the use of telemedicine in the hopes of making care more accessible for patients and reducing overall costs.

And as more providers, patients and insurers gain an understanding of the breadth of services that can be handled via telemedicine, and the limits, patients will likely make more use of telemedicine.

This is good news for patients and employers, who may end up benefiting from lower plan costs, as well as lower out-of-pocket expenses for employees.

Most large health carriers have adopted some form of telemedicine by either contracting with a tech provider to manage the interface or by purchasing a tech platform.

As well, a growing number of established insurers are starting to sell “virtual-first” plans, often with a zero-dollar deductible and no copays for all visits with virtual-only providers.

Potential savings and other benefits

In a study published in the American Journal of Managed Care, researchers at the Perelman School of Medicine at the University of Pennsylvania found that average per-visit costs for hospitals in Penn Medicine’s OnDemand telemedicine program were 23% less than for in-person visits.

Average per-visit costs in the telemedicine program were $380, compared to $439 for in-person primary care offices, emergency departments or urgent care clinics costs.

“The conditions most often handled by OnDemand are low acuity — non-urgent or semi-urgent issues like respiratory infections, sinus infections, and allergies — but incredibly common, so any kind of cost reduction can make a huge difference for controlling employee benefit costs,” the study’s lead researcher, Krisda Chaiyachati, MD, said in a press release.

The study’s authors noted that there are other benefits besides just cost savings.

The program made care easier, which the study’s senior author, David Asch, professor of Medicine, said promotes more care. Since telemedicine is so convenient, people “who might otherwise have let that sore throat go without a check-up may seek one when it’s just a phone call away,” he explained.

Telemedicine services expanding

Before the COVID-19 pandemic uptake of telemedicine had been slow, but usage increased dramatically when hospitals closed to all but emergency cases and as many people were afraid to see their doctors in a health care setting in fear of contracting the disease.

Additionally, Congress in March 2020 enacted legislation that expanded telehealth access for Medicare beneficiaries, leading to a rapid uptake of virtual care.

All that uptake has forever changed perspectives on medical care delivery and the number of visits that can be handled via telemedicine is growing. Initially, hospitals were using it for primary care visits. While that is still the main type of visit for which patients are using telemedicine, uses are expanding to include:

• Urgent care,
• Therapy for behavioral health care visits,
• Specialty care, like dermatology,
• Chronic conditions management, and
• Wellness screenings.

As this technology matures, the number of services that can be handled via video or phone will continue to increase.

Virtual-only plans legislation

Waivers created by the March 2020 CARES Act, an economic rescue package in response to the pandemic, have allowed individuals to choose and buy the use of telehealth services outside of their high-deductible health plan without affecting their health savings account eligibility. Last year, the wavier was extended by legislation through Dec. 31, 2024.

Bipartisan legislation in Congress, the Telehealth Benefit Expansion for Workers Act, would make these waivers permanent and allow employers to offer stand-alone plans to their workers.

It’s envisioned that these stand-alone telehealth benefits would operate similarly to dental and vision benefits, remaining separate from health care plans. They would be another tool for reducing overall medical costs.

According to the bill’s authors, allowing employers to offer stand-alone telehealth coverage would:

• Help alleviate provider shortages,
• Increase access to mental health services,
• Reduce the cost of care for patients by widening provider networks, and
• Provide timely access to medical care to individuals in rural areas.

The bill also would include telehealth access for part-time, seasonal and contracted workers.