Health Plans Consider Telehealth Benefits


Telemedicine’s expansion continues as more insurers are covering these services in 2016. Some health plans, such as BCBS of Alabama began paying for five telehealth services such as behavioral health and stroke in December of last year. There is particular interest among health plans looking to provide access to care in rural areas or for chronic conditions.

Telehealth services can be marketed not only to rural members, but also employees of the internet generation who want on demand services. Insurers are in part embracing these services because of the rapid advances in enabling telehealth technologies. Also in part because a telehealth visit might cost $50, which is much less expensive than a $500 trip to the emergency room.

According to a recent issue of Modern Healthcare, health plans haven’t had reliable data to support claims that telemedicine will reduce healthcare costs, due to its relatively low utilization rate. Additionally, payers are concerned that it will be used as an extra visit, instead of an only visit.

But technology today is moving at such a swift pace improving video equipment and connections, and creating cleaner, sharper telehealth interactions that will hopefully alleviate a duplicative in-person doctor visit.

While more insurers as well as consumers are recognizing the value and need for telemedicine, states have been propelled into action to establish laws and guidelines. There are now 29 states and D.C. that have private telehealth coverage laws and the National Conference of State Legislatures estimates that 32 states will have enacted laws by 2017.

The tricky part for health plans covering members in multiple states will be navigating each state’s statutes as they really vary. Additionally, health plans will have to determine with the help of their providers what services will best support their members’ needs.

Telehealth services can include everything from delivering interactive medical care via a cell phone or laptop, digital CT scans and remote monitoring of chronic conditions. While there are several common services lines that use telehealth applications, this is expanding as primary care services are also becoming the focus under the telehealth umbrella, which would have a more far-reaching effect on more people.

Physician office centers will need to get on board with offering this in their practices, especially since it’s believed most major insurers will include some kind of telehealth benefit going forward. The convenience and cost effectiveness of telemedicine will continue to grow the demand for access to care through technology.
Source: Modern Healthcare. Virtual Reality: More Insurers are Embracing Telehealth. February 2016. Vol. 46. Issue 8.

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