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Part 2

Though the perception of telehealth value may not align perfectly between providers and consumers (as discussed in Part 1) – the common goal of reduced healthcare costs is expected. Plan sponsors who provide telehealth benefits should ensure their telehealth infrastructure supports enough quality communication between user and the telehealth service to substantiate telehealth use. Patients, on the other hand, should do their best to identify avoidable healthcare costs with the telehealth and telecommunication tools available to them.

Telehealth is a convenient virtual healthcare service users and providers can use to help slow down rising health spend. According to National Health Expenditure Projections, health spending is expected to grow on average 5.5% per year and reach $6.0 trillion by 2027.

Consumer-Market Telehealth

The whitepaper, Designing The Consumer-Centered Telehealth & eVisit Experience states that “consumer perceptions of healthcare will continue to evolve and become subject to typical consumer behaviors such as shopping, ratings / reviews, and behavioral economics.” If this is true, telehealth will operate within a consumer-market and telecommunication influence on outcomes will increase.

Third-party telemedicine vendors in the marketplace have begun to compete for the afterhours business that on-call providers are historically reluctant to provide. Some self-insured employers and / or brokers whose provider groups do not offer robust afterhours services have contracted these third-party telemedicine vendors to treat members in need. This cost-effective, on-demand service typically includes providing records of the telehealth visit to the primary physician to promote continuity of care and reduce expensive emergency department use.

Communication Solutions

According to an article on Healthcare Finance, “half of consumers have avoided seeking care altogether” because they find the healthcare system too difficult to navigate on their own. Our I Am! nurse advocacy program was created to connect members with nurse professionals who understand the healthcare system and can promote and encourage improvements in member lifestyle and foster a personal understanding of, and compliance with, medical treatment.

Below are a few telehealth questions our I Am! Nurses believe are important for telehealth users and providers to consider. 

  • Does your plan offer telehealth services? Who pays if the telehealth provider or service is not in-network?
  • Is the telehealth provider willing to order the necessary lab tests, treatment, medications, facility services or radiology studies at an in-network location that is convenient for the member?
  • Will electronically recorded and transmitted health metrics be used to direct telehealth provider decisions?
  • Will EHRs be readily accessible to the diagnosing on-call provider who orders treatment, specialty referrals and immediate referrals to an ER / urgent care facility for an acute problem that cannot be handled remotely?
  • Will providers be more inclined to schedule a follow-up tele-visit to assess the effectiveness of new or changed treatment or medication between appointments as a regular practice?
  • Will providers and on-call providers utilize telemedicine more often to provide sufficient service designed to avoid urgent care or emergency department visits for minor illnesses afterhours?

The website shares research that has shown telehealth clinical outcomes to be “as good as or better than usual care.” Moreover, home monitoring for patients with chronic conditions is a practical telehealth solution for anyone stuck at home and in need of patient counseling.

Click here to learn more about I Am! or to discover how the power of data can unlock telehealth potential.

APH’s I Am! Nurse Advocacy Program provides only administrative, strategic, and analytical services and functions and does not make medical diagnosis, provide medical advice, or prescribe medical treatments or options.


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