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In 2017, a well-publicized RAND Corporation study presented a startling conclusion. It found direct-to-consumer telehealth may not save money because it may increase health care utilization due to ease of access. In fact, researchers estimated an 88 percent increase in the use of specific health care services among patients studied.
With findings that seem contrary to years of other research, the study got lots of play, raising important questions for corporate health benefit programs: Should our company promote plans that offer telemedicine (often called telehealth, virtual visits or remote care)? Or should we urge people to stick with in-person care?
Before you decide, know that the RAND research doesn’t tell the whole story. RAND compared medical claims costs for telehealth users with costs for people seeking in-person care within just one diagnosis group (respiratory illness), and the user group amounted to fewer than 1,000 patients over a 10-month period. Also, the study didn’t take into account telehealth’s holistic benefits, including workplace productivity and timesavings for patients and care providers.
Telemedicine no longer means telephone Originally, telehealth or telemedicine meant just that: health care delivered over a telephone line and mainly to people in rural areas with few hospitals or specialists.
In 2011, the year RAND’s study started, some of today’s most successful direct-to-consumer telehealth services didn’t even exist. Today, people can go online or log into a special medical app on their phone, tablet or computer for a private, secure, face-to-face online visit. Using live video, a doctor or other clinician sees and hears the patient’s concerns and symptoms and prescribes treatment or other steps. Care can happen anywhere, at the consumer’s convenience and in many cases 24/7.
Time and cost savings: why virtual visits pay off
Thousands of studies have looked at the value of this kind of remote care, especially for chronic conditions, follow-up after hospitalization and some types of behavioral health. The cost savings have prompted the federal government and all 50 states to adopt at least some telehealth care for Medicare and Medicaid beneficiaries.
Virtual office visits eliminate the need to spend time getting to and from the office or home, saving time and money, with research showing that 90 percent of people’s health issues can be resolved in just one telehealth visit.
Telehealth’s possibilities are especially compelling for employers where unplanned absences can amount to more than 20 percent of payroll costs each year.
Recent evidence points out why virtual care deserves important consideration:
• Time savings: Citing a time-usage study published in the Journal of the American Medical Association, American Well, one of the leading telehealth companies, points out that virtual visits save 106 minutes per visit on average, compared to in-person care.
• Affordability: Most consumers pay about $50 to $75 for a virtual visit. That’s far less expensive than a $150 visit to an urgent care center or a trip to the ER, which generally costs $1,700 or more.
• Lower ER usage: Doctor on Demand, a telehealth provider, says about 50 percent of its patients would have gone to an emergency room or urgent care if they hadn’t accessed a video visit.
The point is that when it comes to care utilization and cost, it’s important to look at the big picture, not a single study. Numerous studies have drawn conclusions that differ from those of the RAND research. In fact, data analyses of a much larger population (1.8 million people) found that virtual care visits save money, resolving 90 percent of people’s health issues in just one telehealth visit.
How telehealth can help businesses
Telehealth’s possibilities are especially compelling for employers. Unplanned employee absences can amount to more than 20 percent of payroll costs each year.
Fortunately, employees can now get the care they need, anywhere. Today, 75 percent of firms offer employees the option of receiving medical care virtually, according to the Wall Street Journal. And, as of this year, legislatures in all 50 states have passed laws that allow, enable or expand the delivery of telemedicine for residents.
In 10 years, we’ll likely look back to see that telehealth trends may have started with a spike in utilization – but ended with better health outcomes and lower costs overall. And that’s taking good care of employees and the public at large.
Dr. Mayrene Hernandez is the chief medical officer for UnitedHealthcare South Florida/Miami. She is Board Certified in Family Practice and a practicing physician. She holds the position of Clinical Assistant professor at Nova Southeastern University and enjoys being a mentor to future medical students.