Telemedicine Trends Transforming Healthcare. Presented by Jamie Bishop, VP, Employee Benefits February 23, 2016

Transcription

1 Telemedicine Trends Transforming Healthcare Presented by Jamie Bishop, VP, Employee Benefits February 23,

2 Today s Agenda We ll take a dive into Telemedicine trends and the impacts that we are seeing as relates to employee benefit plans. 1) What is Telemedicine 2) Where are we seeing it trending 3) How does it work 4) How is it impacting employee benefit plans 5) When is a good time to discuss alternatives Once we have completed the webinar you should be more knowledgeable on the topic and may want to discuss alternatives available to you. Jamie Bishop, GBA Vice President, Employee Benefits 2

3 What do you know about Telemedicine? My head is in the sand New things make me nervous! Already implemented! 3

4 What is Telemedicine? Definition: Per Wikipedia..the use of telecommunication and information technologies to provide clinical health care from a distance. It helps eliminate distance barriers and can improve access to medical services that may not be consistently available. In Real Life: Imagine that you have an ear infection (same one you get each Spring). You have the option to call a physician, 24/7, talk through your symptoms, get diagnosed via the phone and then get a prescription on the phone. 4

5 High Level Types of Telemedicine Types of Telemedicine: 1) General Care Non Emergency/Non Specialty 2) Telenursing 3) Telepharmacy 4) Telerehabilitation 5) Specialists for Remote Areas Cardiology Psychiatry 5

6 From a Broad Perspective Provide 24x7 access to board-certified physicians via phone, mobile, and video Diagnose, treat and prescribe medications (if necessary) for common health issues Redirect unnecessary ER/UC visits to more cost-effective mode of care 6

7 Who is Benefiting from Telemedicine - Employers Employers: Redirect care to less expensive alternatives 1) Office visit $95 average vs. $45 Telemedicine 2) Urgent Care $181 average vs. $45 Telemedicine Productivity increases 1) Employees access care sooner 2) No waiting for an appointment 7

8 Creating Savings for Employers Cost of Visit Number of Visits Total Office Visits $ $53,116 Urgent Care $ $23,530 Total $76,646 Telemedicine Savings 50% Visits $ $12,195 $14,363 25% UC $45 33 $1,485 $4,488 Total Plan Savings $18,851 *assumes no change in utilization patterns 8

9 Who is Benefiting from Telemedicine - Employees Employees: Cost Advantages 1) For a plan with no office co-payment a) Lower cost option of $45 telemedicine vs. $95 Office visit b) Known cost of a visit versus unknown of going to the office 2) If there is an office visit savings can be shared Convenience 1) No need to make an appointment 2) For families with children it can be a big convenience 9

10 How Does it Work? 1) Member completes brief medical history a) Allergies b) General data 2) Member requests a Consult a) Via a call b) Via mobile face to face 3) Consult with a physician 4) Resolve the Issue 5) Next Steps for Care of the Issue 6) Payment as Needed 10

11 When do they call Telemedicine? Examples of Diagnosis Sinus problems Urinary tract infection Pink eye Bronchitis Upper respiratory infection Nasal congestion Allergies Flu Cough Ear infection 11

12 How are Prescriptions Handled? In the event that the Consult results in a prescription for the member: The Telemedicine vendors use best practices in prescription management Appropriate prescribing following CDC guidelines No controlled substances, psychiatric or lifestyle drugs 98% generic prescribing rate Member convenience Important Note: Not every Consult results in a prescription for the condition. Just like the Doctors office there are times that it s a viral diagnosis or a visit that ends with no prescription. 12

13 Where does it work? Regulations vary by state regarding the use of telephonic visits. VIDEO OR PHONE VISITS WITH RX VIDEO VISITS ONLY WITH RX PHONE VISITS ONLY, WITH RX VISITS UNAVAILABLE 2015 Teladoc, Inc. All rights reserved. 13

14 Determining Your Own Program Review Vendor Proposals Determine Eligibility All Employees Health Plan Employees only Dependent Eligibility Determine Employee Communication Campaign Custom Announcements Letters to the Home Create Education on Costs to Employees If Self-Funded educate on savings potential 14

15 Statistics from Vendor - Teladoc An independent study by Rand revealed: 34 % 21 % 6 % 52 % Visits occurred on weekends and holidays Patients had not sought care in the past year Required a follow-up visit (vs 20% ER) Represent top 3 diagnoses (vs 72% at retail clinics) An independent study by Rand of 300,000 Teladoc participants analyzed 2 years of claims data, conducting a 21-day episode of care analysis. 15

16 Questions Jamie Bishop, GBA Vice President Employee Benefits