Accepting Telemedicine Without Exception

There is an increasing number of private insurers paying for telemedicine service, a trend that is gaining traction and experts say will boost utilization of the service. More than half of states now have laws with rules addressing insurance and telehealth coverage.

Many payers have come to agree that telehealth will help rural members access providers, while also attracting companies that want to deliver modern conveniences to employees of the streaming video generation, who have come to expect on-demand services. Insurers are also hoping telehealth will live up to its hype by keeping people out of more expensive healthcare settings. In addition to offering a lower price, telehealth will lower the wait time many patients experience at in-person clinics and hospitals waiting to be treated for their low acuity ailments. With these very same patients now able to be treated at home, the wait time for others requiring in-person care at emergency departments and urgent cares for more serious cases will decrease.

Looking ahead, telehealth advocates and providers see senior citizens on Medicare as the next major market for growth. Roughly 1 in 5 people older than 65 live outside of a metropolitan area, and seniors usually have worse access to primary-care physicians and specialists if they live in rural areas. Many older adults in urban and suburban areas also face difficulties traveling to their doctors’ offices for frequent appointments. This can be due to lack of travel modalities, physical capabilities, or financial burden. With insurance carriers accepting and offering telemedicine as a legitimate source of healthcare, this will greatly reduce the burden on our aging population.

Health insurers have traditionally, and rightfully resisted paying for a technology that made bold and untested claims about reducing costs. Telemedicine had its beginnings making similar claims, but has the stats to back them up. A $50 telehealth visit to diagnose a sinus infection is much more manageable than a $600 trip to an emergency department. Reducing physician office visits by elderly patients with multiple chronic conditions holds similar potential. Although there are some conditions that require specialty diagnostic equipment and monitoring, many of your everyday conditions can be safely and effectively treated via telemedicine.

There is a strong argument to be made on behalf of telemedicine to those insurance carriers who have yet to accept it. “Do we really want to ration care by inconvenience, or do we want to find ways to deliver valuable care as conveniently and inexpensively as possible?” Dr. David Asch, a professor of medicine and medical ethics at the University of Pennsylvania, wrote in an editorial last November for the Annals of Internal Medicine. 

This simple and caring line of thinking, advocating for the patient is the rationale that has been winning over payers. Dr. Asch concluded saying; “If this provides that opportunity for someone to get care they need, then it’s a good thing.”

As insurance carriers continue the trend of legitimizing telemedicine, utilization leading to patient care and health will increase, cost and dissatisfaction will decrease. In the end, this will mean the best outcome for the patients, the providers will be reimbursed for a growing telemedicine population, and the insurance companies will see increased enrollment in plans that include the service.