Expanded Telemedicine/Virtual Care Landscape Presents Opportunity

When the arrival of COVID-19 made it imperative to limit exposure risks and reduce the strain on our healthcare system, Federal legislation encouraged telemedicine visits through funding and eased restrictions. Providers rapidly ramped up their capabilities and traditional telemedicine usage exploded. Now that so many more people have tried telemedicine, how do employers ensure they keep using it – but also that it’s being used effectively?

It’s important to understand that telemedicine and virtual care services vary based on the specific needs being addressed – primary care, acute episodic care, mental health, physical therapy, or condition-specific treatments such as for cancer or diabetes. We also need to acknowledge that a traditional telemedicine visit is not the same as a virtual visit with one’s personal primary care physician or specialist – while both have a role in healthcare delivery, they differ in terms of patient experience, cost, and likely the overall value of the visit.

Employers need to identify the best possible telemedicine/virtual care resource based on the specific need of the member, and then have a plan for getting members to that particular resource. This can be a complex process, but here’s how to get started:

  1. Identify all of the virtual access points your employees and their families are using (Teladoc, regular physicians, onsite/nearsite clinics, etc.). An employer I worked with recently turned out to have four access points – two different telemedicine vendors, both of which were available through their medical carriers, a virtual interface available through their near-site clinic provider, and virtual visits with plan members’ regular physicians.
  2. Gather data on cost and utilization for each access point. I’ve seen a wide variation in the cost of services offered through different access points. Be careful not to assume that high cost is bad and low cost is good. Rather, understand the value being delivered in each type of visit. The cost of telemedicine services is going up. That’s why it’s more important than ever to identify the services that can be handled virtually and then determine which particular access point should be used. By working through this process with one employer, we were able to identify a significant 5% cost-savings opportunity; sticking with their status quo would have meant a cost increase.
  3. Set up meetings with vendors. Ask vendors for their specific strategies around virtual care and their product and solution roadmaps. Seek to understand how they are addressing payment for virtual visits in their contracting efforts.

From there, figure out where telemedicine and virtual care fits into your broader strategy. Re-evaluate the market to understand current and emerging capabilities. Which vendors’ solutions sync with your objectives? Don’t forget to consider quality and value while analyzing virtual access points. Finally, and maybe most importantly, help your employees and their families know how and when to use the resources that are made available.

The bottom line is this: there is no going back. But with rapid change occurring in virtual care and telemedicine services, employers that don’t act now to develop a strategy and a plan of action may find themselves at the mercy of those in the healthcare space that do.

Mike Smith
by Mike Smith

Partner, Mercer

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