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Telehealth and Self-Insurance: A Match Made in Heaven

Telehealthemployershealth benefitshealth insuranceself-insuranceIndustry News • 3 min read • Aug 7, 2018 12:00:00 AM • Written by: Elie Goodman

With the ongoing rise in health insurance costs – not to mention the uncertainty about America’s healthcare industry – many companies are shifting to self-insurance.

A self-funded health plan can save considerable money each year, especially for businesses that provide access to cost-effective care and educate their staff on making smart healthcare decisions. This is where telehealth comes in – and why telehealth and self-insurance are a perfect match.

The Cost of Healthcare

The Health Care Cost Institute reports that an emergency room visit averaged $1,917 in 2016. That’s a hefty chunk of change, especially since many people who seek care at an ER are in the wrong place. They’re not facing a health emergency – they need treatment for a minor illness or injury.

An urgent care visit is considerably less – averaging $119-$330 or more – according to the Healthcare Bluebook. Still, it can add up quickly, especially for a self-insured company that covers its employees’ health claims. In either case, telehealth delivers a fixed cost, which can help avoid unexpected costs.

What is the best course of action for someone who’s sick, but whose doctor has no appointments? Are drugstore-based clinics viable options? Or what about a child who spikes a fever on the weekend – and it seems worse than an ordinary cold?

The Case for Telehealth

Telehealth is an ideal option for acute care needs like the flu, sinusitis, strep throat, pink eye, and minor injuries – and it’s a perfect match for self-insured companies.

According to The Wall Street Journal, telehealth appointments for nonemergency reasons cost approximately $45. This is drastically less than urgent care or ER – and with equally good health outcomes.

At MeMD, when our members are sick or injured, they can contact us 24/7 for a telemedicine visit. They’re connected with a board-certified emergency medicine physician, licensed nurse practitioner or physician’s assistant in about 11 minutes, and the entire visit is typically completed within 30 minutes. If a patient requires a higher level of treatment, our docs will provide triage care immediately and direct them to the appropriate level of in-person care, such as a visit to an emergency room, local urgent care or primary care physician. To ensure a continuum of care, the patient will receive a safety follow-up call from a Care Coordinator within 24 hours of being referred to a higher level of care to ensure they received proper medical attention.

The Math

Consider this: if 10 employees choose telehealth instead of urgent care for treatment of minor illnesses and injuries, a business can save thousands of dollars – and yet the outcomes with telehealth are identical. A study by Cochrane, a global independent network of researchers, professionals, patients, carers and people interested in health, revealed that study participants with heart disease, diabetes, cholesterol, blood pressure and even mental health and substance abuse problems reported no difference in treatment between face-to-face consultations and teletherapy. In fact, there was some evidence that monitoring via telemedicine improved blood pressure control and even a decrease in LDL “bad” cholesterol.

10 telehealth visits at $45 per visit*: $450

10 urgent care visits at an average of $119-$330 each**: $1,190-$3,300

* Out of pocket expense for the individual; does not include employer monthly membership fee.
**Healthcare Blue Book

The Convenience Factor

No one likes to sit around in a waiting room, especially when they should be home in bed. In-person visits are also an issue for people who can’t afford to take time off work to seek care.

Nothing compares to the speed and convenience of telehealth. Strep throat at 2 a.m.? MeMD will e-prescribe to the closest pharmacy. Minor burn on a Sunday afternoon? The doctor will determine the best course of action. Telehealth removes barriers to care, ensuring that employees will get the treatment they need and get back to work.

The Ripple Effect

When employees have to pay for all or even a portion of their healthcare, there’s a risk they won’t seek treatment, opting instead to suffer through the illness or injury rather than fork out the cash or miss work (and wages).

This is especially true in blue-collar industries and with low-wage employees. However, a health issue that goes untreated can become much more expensive down the line – a ripple effect that can hurt an employee’s long-term health and the business’ bottom line.

Telehealth costs a lot less and is much more convenient, which means employees are much more likely to seek treatment.

Good Business

Companies that self-insure are deeply focused on providing good healthcare for their employees, but are smart about how much they pay for services.

With telehealth, employers can provide access to high-quality, high-value healthcare, when and where employees need it – all at a low cost.

Learn more about how MeMD can add value to a self-insured health plan.

Reach the World. Giving Made Easy with Impact.

Elie Goodman