Opinion
Explanation of Benefits

Turn A Workplace Room Into An Exam Room

Telemedicine may offer employers lower health care costs and higher productivity from workers.

Turn A Workplace Room Into An Exam Room

I’ve supervised from three to 30 people, depending on my newsroom position at the time, over the past 31 years in journalism. Regardless of staff size, I found that one of the most delicate situations to deal with was a co-worker taking time out of a scheduled workday for a doctor’s appointment. Should they go before or after work? Should they go on their lunch hour? If not, do they use sick, vacation or PTO time? If not, do they make up the time? Is it urgent? Can it be rescheduled, because we’re on deadline!

More often than not, I dealt with it by not dealing with it. Go, see your doctor. Take as much time as you need. Hope you feel better. Don’t worry about us; we’ll be fine. Like most supervisors, I hoped my goodwill would be returned in kind some day through make-up time or extra effort.

But now, with the coming of age of telemedicine, supervisors at businesses across the country (including me) can cross that headache off our lists. Telemedicine gives employees the opportunity to have an office visit with their physicians electronically via a secure computer system. They can do that at home during off hours and not miss work. Or they can do that at work during office hours but without the travel time.

Basic telemedicine visits via two-way video or webcams can involve patients and doctors discussing new symptoms, likely diagnoses and possible treatments, or they can be follow-up visits to previous face-to-face visits. More sophisticated telemedicine visits can involve live transmission via mobile health application of vital signs such as temperature, weight, blood sugar, heart rate, blood oxygen level or blood pressure.

Towers Watson, the New York-based benefits consulting firm, recently projected that the use of telemedicine by employees could save employers as much as $6 billion a year. That figure assumes employees and their dependents would use telemedicine to the full, clinically safe extent possible as a one-to-one substitute for visits to the doctor, urgent care center or hospital emergency room. The firm said even low use of such technologies could generate savings in the hundreds of millions of dollars for employers.

Two surveys suggest savvy employers have picked up the scent. A Towers Watson survey of U.S. employers with 1,000 or more employees found that 22 percent offer telemedicine as a covered health insurance benefit this year, and 37 percent will or intend to in 2015. Another 34 percent said they will consider adding a telemedicine benefit in 2016 or 2017. A separate survey of nearly 600 employers by the National Business Group on Health revealed that offering a telemedicine benefit or access to telemedicine services ranked second on a list of 15 strategies that best-performing companies—in terms of controlling health care costs—intend to take in 2015 to stay that way.

And employees don’t seem to mind. In fact, the number of “e-visits” between patients and doctors is projected to reach 75 million in the United States and Canada this year, up 400 percent from 2012, according to a recent report from Deloitte.

With patients’ acceptance of telemedicine and employers’ willingness to pay for it, health care providers aren’t far behind. Some 46 percent of more than 400 hospitals and physician’s offices surveyed by HIMSS Analytics said they have telemedicine capabilities to hook them up to patients electronically. Another 23 percent said they intend to acquire telemedicine capabilities within the next 24 months.

For example, local business entrepreneur Thompson Aderinkomi launched RetraceHealth in Minneapolis several years ago to make access to primary care services easier and cheaper by using telemedicine. RetraceHealth charges $49 for a video visit with a licensed clinician and $149 for a house call if the video visit determines that a face-to-face assessment is needed. By comparison, the average charge for a physician office visit ranges from $163 for a child to $228 for a senior, according to the latest available government statistics.

Twenty-one states and the District of Columbia require private health insurers to cover telemedicine services, according to the American Telemedicine Association, but Minnesota is not one of them. That means employers or employees in the state would have to pay health care providers directly out of pocket for that care if their carrier doesn’t voluntarily offer telemedicine as a covered benefit.

expbenefits_S01.jpg

So what does all this mean for employers? Here are my five recommendations for those interested in telemedicine to lower their health care costs and increase employee productivity. Employers should:

  • Ask their health insurers if they offer telemedicine as a benefit. (Encourage them to if they don’t.)
  • Lobby their state legislature to mandate telemedicine as a covered benefit.
  • Identify the health care providers in their market that offer telemedicine as a service.
  • Educate employees on the use of various telemedicine technologies.
  • Designate private space to allow employees to have e-visits with doctors during work hours.

As a former supervisor, I can tell you that any of those are a lot easier than asking someone else to stay late on deadline because a co-worker needed to leave early to go to the doctor.

Short take

Most employers say complying with the benefits requirements of the Patient Protection and Affordable Care Act will end up increasing their health care costs this year, according to a survey of nearly 700 employer members of the International Foundation of Employee Benefit Plans. Specifically, 47 percent said they anticipate a 1 to 4 percent increase; 27 percent said they anticipate a 5 to 10 percent increase; and 14 percent said they anticipate more than a 10 percent increase. Only 12 percent said they anticipate no change or a decrease in health care costs this year thanks to the ACA. Yet less than 1 percent said they plan on discontinuing employer-based health benefits in 2015. You don’t have to be an economist to know that someone has to pay for those additional costs, and that “someone” likely will be employees, through higher premiums, deductibles and out-of-pocket costs.

Update

In September, we wrote about the time being right for an expected boom in domestic medical tourism. Well, it may not be a tough sell, especially for people living in rural areas. Figures released by the feds in July show that 40 percent of the 6.1 million rural residents who needed hospital care in 2010 traveled to urban hospitals. Just think how many more would do the same if care were better and cheaper and the price was known ahead of time.

David Burda (twitter.com/@davidrburda, dburda@msp-c.com) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.

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