Does Telemedicine From Your Insurance Carrier Work?

Telemedicine benefits aren’t just a passing employee benefits trend. More than 80% of large employers surveyed by Towers Watson say they will offer a telemedicine benefit by 2018. As a result, carriers are offering telemedicine in their major medical plans. Your clients might have the opportunity to choose their carrier’s telemedicine benefit–but before you promote this option for its convenience, it’s essential to remember that carrier-provided telemedicine and employer-provided options are much, much different; it's apples to oranges.

Carriers are adopting telemedicine in ways that will never allow employers or employees to realize the full value of this new healthcare delivery method. As a broker, you need to be able to identify where the real savings and value will be for your clients.

Here are three reasons telemedicine benefits through a carrier just doesn’t hit the mark for your clients:

1. The carrier sees it as just another way to generate a claim.

Telemedicine is more than a “perk” for employees. It is much different from a nurse line–but unfortunately, many carriers package it in a similar way.

When a telemedicine consultation is completed through a carrier, copays are charged to employees and claims are created and processed. From the employee’s perspective, it operates just like using their insurance to see a doctor in-person, except they can do so from their home. This is just another claim your carrier can charge you for.

Even if your clients offer generous medical benefits, telemedicine saves employees two to four hours of waiting in a doctor’s office or 19 days trying to even see the doctor. This could be an incredible way to give your employees time and money back–not just a reason for your carrier to generate another claim.

2. There’s little (or no) engagement strategy.

Employees are already wary of insurance. We’ve all been there: Costs of healthcare are opaque, and we never know when surprise charges will pop up as we’re checking out at the urgent care.

So when we find out there’s been a change in our coverage, we delay care. We wait it out because changes in healthcare and cost-shifting are intimidating. We don’t want to face the high deductibles and larger co-pays that many major medical plans now require.

The telemedicine companies you recommend should engage and encourage your clients’ employees. If your employees never understand and feel comfortable with their telemedicine benefit, they won’t utilize it. Which won’t benefit anyone, and your clients will be wasting their money.

The carrier does not provide education around how to use it or why to use it when telemedicine comes as a supplement from your carrier. They do not have in-depth, long-term engagement strategies that will constantly increase utilization and drive savings.

3. These low utilization rates kill ROI and savings, anyway.

The lack of communication and engagement is the reason why the average carrier-provided telemedicine utilization rate is 1%. With such a low percentage of employees using the benefit, it won’t be driving nearly as much savings in healthcare costs and productivity costs as it could be.

This is especially true when telemedicine companies charge a co-pay: If the $40 telemedicine co-pay is just as much as going to an Urgent Care of physician visit, the employees will not change the way they access healthcare by making the telemedicine call.

This is why choosing a carrier-provided telemedicine benefit with a low PEPM provides almost no value to your clients and their employees. But choosing a provider with a higher PEPM, like TelaCare, also comes with an average utilization rate of 43.5%. We drive an average of 37% direct return on investment with our customized engagement strategy––while competitors with low utilization actually cost you -72% ROI.

The Diagnosis

Telemedicine is not just a small piece of your insurance benefits. It’s a comprehensive service that can save covered members thousands of dollars in healthcare bills each year. But a telemedicine plan inside a major medical plan drives almost no savings. If you've encouraged your clients to pay extra PEPM for it, a quick calculation may show you that they’re not actually getting any value out of it––and neither are their employees!

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