While there's a wide range of how reimbursement for telemedicine is handled, payers will inevitably get more comfortable paying for these types of services as they become a larger part of our healthcare delivery system, said Dan Bensimhon, M.D., the founder and CEO of MLS Telehealth, a staffing company based in Greensboro, N.C. Regardless, telehealth is seen as a tool to bring down costs for both patients and providers.
A lot of health systems will provide telehealth as a service, because it expands their service area, improves the quality of care, and prevents patients from coming to the emergency room for non-emergent issues. Others offer it as a benefit to their employees, because telehealth is often the lower-cost solution.
Payers also embrace telemedicine for specialist visits, said Patrick Tellez, CMO of North County Health Services in San Diego, Calif. “Provider coverage of this service will enable primary care providers and specialists to collaborate to benefit many patients in the primary care setting,” he said. “E-consulting offers a readily available solution to enhance specialty care access, and improved service to members, yet lowers the frequency with which face-to-face specialty care visits are needed.”
With Jeff Connect, the telemedicine program used at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, most video visits are $49, which is sometimes the responsibility of the patient, but can often be billed to insurance. “If part of the telehealth visit is covered under bundled care, it may not be billed and it may be free,” said Judd Hollander, M.D., associate dean for strategic health initiatives, professor and vice chair of finances and healthcare enterprises in the department of emergency medicine.
This predictable cost is appealing to consumers who are skeptical and afraid of the unknown when it comes to medical expenses. Sixty-two percent of Americans believe that online visits with a doctor should cost less than in-person care, according to the American Well survey.
Driving down costs can be equally as important as saving time, as is the case with post-surgery video visits.
For thoracic surgeons at the University of Maryland Medical System, a nurse practitioner and a patient will conduct a telemedicine visit 24 hours after the patient goes home. “The NP will see the wound, and it saves
patients from running back in,” said Marc T. Zubrow, M.D., vice president for telemedicine and medical director of eCare at the system. “You can reassure a patient that it is healing as it should, or you can take care of a problem sooner—a patient might be hemorrhaging and doesn't realize it's a problem.”
Reducing wasted time—taking off from work, traveling to and from a medical office, and waiting to be seen—may be telehealth's strongest benefit.
“The best thing about video is that it's immediate,” said Pearl. “Rather than patients having to schedule a visit for a future date, they can be seen, evaluated, and treated immediately for a range of medical problems.”