Telemedicine allows patients to communicate and interact with health care professionals outside of the traditional medical office structure. Over the last decade, the number of employer groups that offer telemedicine either through an outside vendor or through their health plan has steadily increased to 88% while usage has hovered between 8% – 10% according to a national survey of employer sponsored health plans by Mercer.


Employers and insurance carriers have long seen the value of telemedicine and its potential for reducing costs and absenteeism, but employee usage has not increased much over the last few years despite the increased access and the expressed interest by employees to have telemedicine included in their benefits offerings.


The growth in the usage of telemedicine services since March and the beginning of the COVID-19 pandemic has been exponential. According to the Fair Health Monthly Telehealth Regional Tracker, the percentage of medical claims in April 2020 rose to 13%.

Before the COVID-19 pandemic, there was very little change in the usage by consumers of tele- medicine, but in March, as statewide shut-downs began to require people to shelter at home, telemedicine usage increased almost 2,000% from the prior month and over 4,000% more than in March of the prior year.

The increase in telemedicine usage is not only a result of the stay-at-home orders and people’s inability to access traditional health care, but also a result of legislative changes around telemedicine services.

The President and CMS temporarily broadened access to Medicare telehealth services including:

  • Telehealth visits to be considered the same as an in-person visit and reimbursed at the same rate.
  • Medicare would now pay for office and hospital visits via telehealth from patient’s places of residency.
  • Increased flexibility in waiving cost-sharing for some telehealth visits.
  • Relaxation of HIPAA rules related to privacy to allow use of video conferencing platforms such as Zoom to conduct virtual visits.

Private health plans also relaxed some of their restrictions on telemedicine. During the pandemic, the easement of some of the restrictions on telemedicine have made it easier for patients to continue their care and access treatment while limiting the spread of infection for both the patient and the health care providers.

The benefits of telemedicine exist by making it easier and quicker for a patient to see a health care professional, keeps non-emergencies out of the hospitals, allows for shorter visits, reduces cost, and facilitates the monitoring of care.


The growth experienced in telemedicine over the last several months can only be sustained if providers have a better understanding of how telehealth services will be treated in the long run. Providers have to decide whether to invest in upgrading their technology to better meet the demands of the various telehealth services and health insurance carriers without knowing if they will continue to be reimbursed at the same rate as treating their patients in person.


While it is unlikely that the utilization rates of telehealth services will remain at the same level as they have been during the first months of the pandemic, telehealth will be an integral part of the health care system in the future. Employers should encourage employees to use telehealth and provide them with information to help them understand telehealth services and access it through the company sponsored health
plans.

Source: Heffernan Benefits Advisory Services 11th
Annual Health Care Trend Report 2020