One of the biggest ways that healthcare is going non-traditional is with the new phenomenon of telemedicine, which is the use of medical information exchanged from one site to another via electronic communications. In a practical application, telemedicine could involve any of these scenarios:
- Patients sending their list of symptoms to their provider via email or electronic form
- “Phone appointments” with physicians, which include symptom analysis and diagnosis
- Lab results being delivered via phone or email
- Prescriptions being emailed by the provider, then printed by the patient for fulfillment at a local pharmacy
- Prescriptions being emailed by the provider to the patient, and then fulfilled/mailed to the patient
Why should employers know about telemedicine? Because experts are calling it a possible new strategy for reducing health insurance costs. This makes sense, as receiving clinical services remotely can reduce the amount of time employees spend away from work. It can also improve access to healthcare services for employers in rural areas. If the employer partners with a network that offers telemedicine, it can greatly improve the chances of retaining local employees. The last thing any employer wants is to lose its staff because the location offered poor access to healthcare.
Is telemedicine perfect? No, at least not yet; some of the potential problems experts have pointed to include legal and regulatory issues at the state level, privacy concerns and low physician buy-in – not to mention the potential for claims reimbursement issues. “Telemedicine reimbursement claims are treated differently from in-person care by physicians,” one recent study revealed. “Barriers to reimbursement include greater denials for (telemedicine) services than for in-person services, billing and coding issues, and a pre-authorization requirement for telemedicine services not needed for traditional care.” This should be expected in the early adoption stage, but as telemedicine becomes more mainstream, it seems natural that insurance companies will create streamlined models for reimbursing physicians who provide telemedicine services.
For employers that want to improve access for employees and watch out for the company’s bottom line, embracing telemedicine is one new strategy that may pay off. GM&A gladly works with providers who deliver telemedicine services; if you are one such provider, feel free to contact us.