Telemedicine – follow the money

Dr. Weeks’ Comment: We’d like to think that science drives medical practice. Yup.  However, it seems that in health care, as elsewhere, we follow the money trail.  Telemedicine is hated by profit-minded doctors who like to have patients come to the office not only for face to face conversation (all 1 minute of it, in many instances, all the while the doctor’s eyes are on the compute screen or the prescription pad!)  but also for enhanced billing opportunities. But telemedicine has always offered a great opportunity to cost effective and convenient care. Of course, the doctors can’t be careless and when necessary, must insist on a patient visit.


Employers Eye Telemedicine to Cut Insurance Costs

Healthcare access and delivery seen as last frontier for savings
Having squeezed all they can out of health plan design, employers are now pinning their hopes on telemedicine as the way to bring down their health insurance costs.
Telemedicine is growing rapidly and within a few years will be a routine part of healthcare plans offered by employers, according to the president and CEO of the National Business Group on Health (NBGH), a nonprofit association of 425 large employers.
Brian Marcotte said employers have moved away from issues of plan design, pretty much accepting that there is little chance of improvement there, and are now focusing on how healthcare is accessed and delivered.
Ninety percent of employers will make telemedicine services available to employees in states where it is allowed next year, a sharp increase from 70% this year, according to an annual survey by NBGH.
That figure will rise to virtually 100% by 2020, Marcotte said. He presented the survey findings at the National Press Club in Washington, DC.
The great appeal of telemedicine is that it comes at a lower cost than other care access points, Marcotte said. An emergency visit costs an average $700 per visit, urgent care $150, and a physician office visit $100. A telemedicine session? About $40.
Employers are leveraging the fact that most people have a smartphone with which to access healthcare. That bypasses a pain point both patients and employers loudly complain about, the way a 15-minute talk with a doctor can require nearly a full day off work to travel to the office and wait.
Nowhere Else to Cut
The focus on delivery comes because efficiencies on the front end have been pretty much exhausted. Employers have realized that once you go to a high deductible health plan, there’s not much more you can do to save money on the plan design, Marcotte said.
A few tweaks here and there maybe, but nothing that really makes a difference.
“You really have to train your sights on the delivery system if you want to drive efficiencies and control healthcare costs,” he said.
In addition to telehealth, employers are focusing on other factors at the point of delivery, Marcotte said. There is more interest in accountable care organizations, high performance networks, and the expansion of centers of excellence beyond transplants and into areas such as bariatric surgery, orthopedics, cancer, and fertility.
This report is brought to you by HealthLeaders Media.

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