benefitexpress April 26, 2021 13 min read

The Future of Benefits: Telehealth Has Entered the Mainstream, but There's Still Rough Water Ahead

Exploring the future of telehealth after the COVID-19 pandemic

As we discussed in our introductory Future of Benefits post, employee acceptance and use of telehealth offerings exploded in 2020 and that momentum has carried over into 2021.

According to a March 2021 CDC webinar on the role of telehealth in expanding access to healthcare, telehealth usage has expanded rapidly over the last 12 months.

Nearly one third of health visits at HRSA-funded Federally Qualified Health Centers were conducted using telehealth over the past year. And nearly half of all physicians (48 percent) reported treating patients through telemedicine in 2020—up from just 18 percent in 2018, according to a survey conducted by Merritt Hawkins, a physician search firm, in collaboration with The Physicians Foundation.

Of course, the percentage of weekly health care visits conducted via telehealth since 2020, as tracked by CDC have varied, dropping when COVID-19 cases decrease and plateauing as cases increase. Also note that CDC stats only capture data from voluntary reporting.

But it seems likely that telehealth usage and utility will continue increasing even as COVID-related usage declines. Employees who have used telehealth during the pandemic now understand the potential for time and cost savings, have experienced the value of convenient access to qualified medical experts, and most are confident in the quality of care provided via smartphone and computer.

In terms of demand, employees, especially the younger workers who make up a rapidly increasing percentage of the workforce, expect more and better virtual options that improve access to telehealth platforms and providers.

Telehealth can also play a critical role towards enhancing the U.S. health care system’s capacity to equitably provide efficient and affordable care to all patients.

Consider the efforts — and results achieved — by benefitexpress client, Metro Nashville Public Schools, a true innovator in the space. In addition to in-person care, MNPS’ MyMaternityHealth includes a telemedicine component; “employees are mailed a fetal heart tone monitor, scale and blood pressure cuff they can use at home during digital visits. Women with low-risk pregnancies can conduct up to eight of their 12 prenatal visits through telemedicine — an option that allows them to practice social distancing during the pandemic.

Health policy makers recognize telehealth is a powerful tool for improving affordable, accessible, quality health care, especially among populations and in regions with limited access to onsite care facilities (ER, Primary Care provider facilities, Urgent Care).

Their input will determine political attention and help drive continued promotion (and oversight) of telehealth by federal agencies.

And the value of telehealth services makes offering tightly integrated telehealth benefits a powerful asset in employers’ talent management and cost control toolboxes.

But employers will need telehealth providers and insurers to keep increasing the value of those programs as well. Approval, payment, and reimbursement processes need to achieve parity with other health and wellness programs. And more attention needs to be paid to intelligent cost control.

Telehealth can be improved for patients, providers and employers

Areas in need of improvement have become clearer as telehealth usage has risen rapidly.

Along with employee expectations of expanded telehealth options in their benefits packages (especially among younger employees) come expectations around the breadth and quality of those options. And there are some challenges here for employers, providers, and insurers. For telehealth to reach its potential in terms of quality of care, affordability, and ease of use, employers’ needs must also be better addressed.

Looking forward, it’s likely organizations will further expand virtual care options to include physical therapy; weight management; chronic care management for diabetes, cardiovascular disease, prenatal care, and more.

As options expand, organizations and their benefits administration partners will need to devote more resources to managing outcomes and controlling the cost of virtual care programs. More attention will have to be paid, as well, to measuring the effectiveness of, and patient experience with, telehealth. And all stakeholders will need to work together to better balance virtual vs. in-person care.

In a January 2021 article, “Health Costs And Financing: Challenges And Strategies For A New Administration” in the journal HealthAffairs, the authors write “As the logistics and infrastructure to support home-based care [including telehealth] mature, reimbursement and financing models present a substantial barrier to widespread adoption.”

Specifically, the article continues, “Although telehealth services were reimbursed by many payers before 2020, payment rates did not support the process and workflow changes needed for adoption at scale… Shifting care to the most appropriate and cost-effective settings will require permanent reimbursement changes for telehealth.”

Other barriers remain, including uneven understanding of and unequal access to technology, user experience design failures, and slow integration of telehealth into total benefit programs.

Employers should work with professional associations and other allies to encourage permanent changes to telehealth reimbursement policies instituted under the COVID-19 public health emergency. Provider and employer/employee needs include equal treatment and payment for in-person and audiovisual telehealth visits, possibly with lower payments and reimbursements for voice-only, chat, or delayed response consultations.

Then the really hard work will continue, translating changing policies into benefits processes and communicating those changes to employees, benefits partners, and regulators.

Behavioral health and telehealth

Telehealth for “behavioral health,” which includes substance-abuse and addiction treatment, has been permanently transformed by the COVID crisis. And the vast majority of those changes have improved treatment options and affordability.

According to experts, access to virtual behavioral health visits can lower the rate of expensive no-shows at counseling sessions and medication management appointments.

Barriers to more widespread telehealth use have included licensing and reimbursement issues, the reluctance of insurers to create new benefits, and providers’ concerns about their relationships with patients.

Although the response to COVID-19 has diminished some of these barriers, implementing telehealth for behavioral health at scale will confront issues of privacy, quality, program integrity, and design of payment models.

Communications strategy for Telehealth

Telehealth is much more familiar to many more employees, but inertia is still keeping many who have access from taking full advantage of this powerful benefit. And with more employers adding or enhancing telehealth still more need to get familiar fast.

Luckily, the same tool will help employers and brokers address both those issues – a focused, sustained communications campaign.

Ask yourself these questions to see if your benefits communication strategy is on the right track:

Personalized: it is the message speaking directly to employees’ questions and concerns, or is it just another generic benefits infomercial they’ll ignore or even resent? Consider using a dedicated microsite that answers employees’ questions.

Targeted: By integrating your telehealth communication efforts with a benefits management platform you could identify opportunities to encourage specific employees to use telehealth options instead of relying on emergency rooms and guide them using push notifications, text messages or email alerts.

Timely: Take advantage of your benefits technology provider’s push notifications feature so you can get messages about new or improved telehealth options to employees on their phone, with a link to your telehealth provider embedded in the message, along with details on what information they should have ready when they call.

Accessible:  Is this information presented in a format that makes sense to each employee and job type? Telehealth can be especially useful for employees who are in the field every day or who work odd hours.

Up next: Mental health and wellness

Our next article in this series will take a close look at why mental health and wellness programs must be tightly integrated into holistic plans for care, communications, patient support, reimbursement and more. benefitexpress Chief Human Resources Officer, Korrie Bird will also share information about our own #BEtterTogether program, designed to help employees deal with some of the stresses created by the pandemic and to support their efforts to contribute to their communities.

Catch up on Part 1 of this series. Then, get your next article delivered straight to your inbox. Click here to subscribe to our weekly newsletter.