A recent research paper in Health Affairs noted that “12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization” — meaning that 88% of the people who used telemedicine for acute respiratory illnesses probably would not have otherwise gone to the doctor. This increased the plan costs by $45 per telehealth user.
So, let’s back up a bit here. What is telehealth? Telehealth connects a patient with a provider using technology – this can be a phone call, an online chat or a video conference to conduct what would otherwise be a normal office visit, and can only be used for certain ailments. The thought is that this convenience will allow members to easily access car for certain conditions (especially if in a remote location) at a fraction of the cost. However, don’t expect to use telehealth for a broken arm or chest pain – go to the emergency room, instead.
There are some key things to take away from this study, but don’t drop your telehealth benefits yet!
First, while the study had a large sample and covered several years of claims, it did only analyze one diagnosis: respiratory illness. So, it is really limited in its applicability to assessing the costs for all telemedicine visits.
Next, keep in mind that some of the “new utilization” generated may have actually prevented larger claims down the road. Some of those patients who would have otherwise skipped a traditional office visit may have developed pneumonia or other more complicated and expensive illnesses as a result of the lack of care without telemedicine.
Monitoring your telemedicine utilization and expense is definitely something to keep an eye on; and if you are an employer who has access to claims data, you might want to investigate claims activity before and after introducing telemedicine (if possible).
Lastly, remember that not all benefits like this are in place to reduce costs. Providing a benefit that makes care convenient can be valuable to your employees! So, take these evaluations with a grain of salt and step back and remember why you introduced them in the first place. My guess is that even if your population uses this benefit a bit more, the additional $45 per utilizing member is probably worth the expense, given your total health care spend.