Telemedicine as an Employer Benefit

Melinda Schriver, MHA, MBA

Telehealth Strategic Solutions

UPMC Insurance Services Division, UPMC Health Plan

• Drive employees to lower costs of appropriate care

• Reduce costs associated with chronic and acute conditions

• Decrease lost productivity

• Promote employee health

• Recognize the need for alternatives to the current health care delivery systems

Drivers of Employer Interest in Telemedicine

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• Save money – lower cost visit

• Save time – less time required

• Easy, convenient access to care

• Increase in High Deductible, Consumer-Driven Health Plans

Drivers of Employee Interest in Telemedicine

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2016 Emerging Trends in Health Care Survey – 67% of employers offer electronic physician visits today.

– By 2018, that number could increase to 90%.

2017 Behavioral Health Survey– Employers interested in mobile apps to help employees manage behavioral

health needs:

– Stress reduction or resiliency; anxiety; and sleep disorders.

2016 21st Annual Best Practices – Drive employees to telemedicine rather than higher costs sources of care (ED,

UC, PCP)

Employer Adoption of Telemedicine as a Benefit:Willis Towers Watson Surveys

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Employer Adoption of Telemedicine as a Benefit:Recent Trends

Use of Telemedicine and Onsite or Near-Site Services

Source: 2016 21st Annual Willis Towers Watson Best Practices in Health Care Employer Survey. Sample includes companies with 1,000 or more employees.5

• Growth fueled in part by enrollment in high-deductible consumer-directed health plans (29% of all covered employees)

Employer Adoption of Telemedicine as a Benefit: Recent Trends

48% 22% 20% 10%

0% 20% 40% 60% 80% 100%

2015

National Business Group on Health

2016 2017 2020

Mercer National Survey of Employer-Sponsored Health Plans

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Willis Towers Watson 21st Annual Best Practices in Health Care Employer Survey (Summer 2016)

• Health care cost expected to rise more than last year

• Costs to rise much higher than the general inflation trend

• Total costs (employer and employee) will approach $13,000 per person by 2017

• Employers concerned about affordability for employees, given stagnant wage increases. Healthier and more financially secure employees are more productive.

Background: Projected Health Care Cost Increases

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Background: Employer Health Care Costs

Health Care Cost Increases Before and After Plan Design Changes

8Source: High-Performance Insights – Best Practices in Health Care: 2016 Health Care Financial Benchmark Survey

Employer Health Care Costs

Wide Variance of Costs Across Industries

9Source: High-Performance Insights – Best Practices in Health Care: 2016 Health Care Financial Benchmark Survey

Lost Employee Productivity

• Hours or days lost to off site, health-related, patient care visits for both urgent care and management of chronic diseases

• Absenteeism costs include direct payroll costs and indirect costs, including:

– Overtime to co-workers covering work of absent employees

– Costs of temporary workers

• Productivity losses related to personal and family health problems cost US employers $1,685 per employee per year.

(Source: CDC at www.cdc.gov/workplacehealthpromotion/model/evaluation/productivity.html)

Background: Employer Health Care Costs

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• No single definition

• Terms used include telemedicine, telehealth, virtual visits, e-visits

• Generally: use of digital technologies to facilitate health care interaction between individuals not located in the same room

Telemedicine: Defined

Tabletop Kiosk by American Well, https://www.americanwell.com/telehealth-platform-mobile-web-kiosk/

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Telemedicine: Modes of Service Delivery

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Telemedicine: Modes of Service Delivery - Asynchronous

13 Source: Dixon RF, Rao L. Asynchronous virtual visits for the follow-up of chronic conditions. Telemedicine and e-Health 2014;20:669-672.

Telemedicine: Modes of Service Delivery - Synchronous

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Telemedicine: Modes of Service Delivery – Remote Monitoring

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Telemedicine: Modes of Service Delivery – Mobile

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• Increased productivity

• Improved employee retention

• Healthier employee population

• Reduced health care costs (average)

– Virtual visit is < $50

– Retail Clinic visit ~ $77

– Primary Care visit ~ $112

– Urgent Care visit ~ $160

– ED visit ~ $1,454

Benefits of Telemedicine for Employers

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Emergency Room$1,454

Urgent Care$156

Doctor’s Office$112

Retail Clinic$77

VirtualAcute Care

<$50

Cost Savings from Urgent Care Telemedicine Benefit to Employees

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Directing Employees to the Right CareExample: Employer Group of 20,000

Source: Employer Best Practices in Telehealth, American Well, 2015.

Cost Savings from Urgent Care Telemedicine Benefit to Employees

19 Source: Employer Best Practices in Telehealth, American Well, 2015.

Employer Benefits

20 Source: Employer Best Practices in Telehealth, American Well, 2015.

• No travel costs

– Visit available anywhere

• No unpaid time or no use of paid time off

– Available 24/7

• Reduced out of pocket costs

• Ability to see trusted providers

• Faster care

– No need to wait for a scheduled visit

Benefits of Telemedicine for Employees

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• Reduced costs

• Healthier member population

• Member retention

Benefits of Telemedicine for Payers

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• Low-Acuity Urgent Care

• Follow-Up

• Wellness and Health Coaching

– Diet and nutrition

– Diabetes education

– Smoking cessation

• Behavioral Health

• Occupational Health

Typical Virtual Visits

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• Apps/Web Only

• Only Telemedicine Clinic

• Onsite Clinic and Telemedicine

Offering Telemedicine as an Employee Benefit

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• Existing app available to employees

• Customized benefit

– Cost share with employee

– Free visit for employees

• Mercer Survey:

– 75% of employers offering telemedicine share the cost with employees; co-pay around $25

Offering Telemedicine as an Employee Benefit

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• Employee choice of health care provider.

• Live video visits.

• Benefit integration.

• Regulatory compliance.

• Marketing support to drive awareness and utilization.

Choosing a Telemedicine Service as a Benefit

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Vendor

• Enroll employees

• Raise awareness to encourage utilization

• Branding opportunities

Increase Employee Enrollment and Utilization

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• Make it available to everyone.

• Leverage executive champions.

• Educate employees about the benefit.

• Offer incentives for enrollment.

• Provide a secure, private space.

• Measure, manage, and share the results.

Best Practices for Employer Telehealth

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• # Employees Enrolled

• # Employee Visits

• Top Diagnoses

• Top Prescriptions

• # Referrals

• Satisfaction Scores

• Health Care Cost Savings

• Productivity Savings

• Program Cost

• Program ROI

Reporting Available to Employers

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Thank you.

Q&A Session

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