U.S. employers make big push for telehealth

NEW YORK (Reuters) - As Hurricane Irma lashed Orlando, Florida, last month, Amanda Leite needed a doctor for her 4-year-old daughter, who had a fever.

FILE PICTURE: Nurse Health Practitioner Rachelle Quimpo (C) introduces patient Shreya Sasaki to Dr. Heidi Meyer, MD Family Medicine, who appears on a video screen remotely at a newly opened Kaiser Permanente health clinic inside a Target retail department store in San Diego, California November 17, 2014. REUTERS/Mike Blake

Finding a pediatrician’s office with both electricity and a doctor on call was not an option. Neither was breaking curfew to get to an emergency room.

Until then, Leite had never thought about telehealth, which is seeing a doctor via video chat. The service is now offered through most major health insurance systems with a copay equal to that of a traditional doctor’s office visit. It can also be obtained independently for per-use costs that vary by provider and locale. Teladoc Inc, the largest provider in the United States, says it sees about 5,000 patients a day, for an out-of-pocket fee of $45 or less.

Leite then remembered a notice she had seen on Facebook from Nemours Children’s Hospital that its telehealth app, which is serviced through American Well, would be free for those affected by the storm.

Within minutes, she had a doctor on her phone screen who had access to her daughter’s electronic health record. They did a basic exam, with Leite pressing on her daughter’s stomach, weighing her and holding her phone to the child’s mouth so the doctor could see her throat.

The doctor determined that rushing to the hospital was not necessary, and that the girl could wait to see her regular doctor when the storm cleared.

“It made me feel a lot better that I didn’t need to rush her to ER,” said Leite, 37.

She is now sold on using a doctor online for future occasions when she is unable to travel or when the illness requires no immediate hands-on exam.


Employers hope this concept of gaining remote access to doctors catches on quickly, because it promises cost savings. As companies start the annual process of open enrollment for healthcare benefits for the coming year, expect a big push by Corporate America to promote the availability of telehealth.

U.S. companies are facing a 4.3 percent increase in health benefit costs for 2018, the highest since 2011, according to benefit consultant Mercer, and are looking for options beyond raising deductibles or copays, which shifts the burden to employees.

Five years ago, only 7 percent of companies covered telehealth visits through health insurance plans, but today, 96 percent of companies treat them like regular doctor’s visits, according to a survey released in August by the National Business Group on Health, a nonpartisan research group.

Usage rates are low, however, with only 2.5 percent of employees at companies surveyed actually using the service, because the availability is so new.

“It’s becoming a more accepted practice now,” said Steve Wojcik, vice president of public policy at the National Business Group on Health. Getting more people on board is a matter of effective communication - companies that are the most proactive about publicizing telehealth to their employees tend to obtain the best response rates.

Craft retailer Michaels Companies Inc, which uses the Teladoc system for its employees, has a usage rate of about 4 percent among its full-time employees. Sharon Brown, director of benefits, is encouraging workers to use it because she thinks it saves money compared with going to an emergency room or urgent care facility.

“We have shift workers, and they can’t always get to the doctor when it is open,” said Brown. “They are saving time, so there’s a productivity cost. It’s less money out of their pockets for travel or lost time at work.”

To reach employees this year, Brown is sending out postcards and magnets. But her most effective messaging is something she calls the Porcelain Post - messages from human resources that get taped up in bathroom stalls across their 1,300 stores, distribution centers and manufacturing plants.

Staffing company Adecco Group AG uses the American Well system for telehealth, and the head of human resources walks around the North American headquarters in Jacksonville, Florida, handing out Starbucks gift cards to employees who have downloaded the telehealth app. It had 28 percent of U.S. employees sign up, and 55 percent used the service in its first year, for a cost savings to the employer of $130,000, said Michelle Gile, a senior vice president for American Well.

Some independent research is a little less rosy. A March 2017 study in Health Affairs found that the costs of treating bronchitis and similar conditions increased by $45 per user when telehealth was involved - mostly because the availability of telehealth encouraged more doctor care, not less.

Some of those seeking care did not have a regular doctor. Some were using telehealth as a precursor to an office visit, like triage, said Scott Ashwood, an associate policy researcher at the nonpartisan Rand Corporation, who led the study.

The American Medical Association backs telehealth as “an ongoing evolution of new models for the delivery of care and patient-physician interactions.” But the organization also cautions that providers recognize the “limitations of the relevant technologies and take appropriate steps to overcome those limitations,” said AMA board member Jack Resneck in a 2016 statement.

“It’s not for everything,” said NBGH’s Wojcik. “There are some times when you need to go see a physician in person. But for a lot of primary care situations, you can probably talk through telehealth. And I think financially, everyone wins.”

Editing by Lauren Young and Matthew Lewis