Telehealth, also known as virtual health care, offers patients the opportunity to see a doctor from almost anywhere if the patient and doctor have access to an online connection. It can be done on a laptop or desktop computer, tablet, or smartphone.
Small business group health insurance plans have offered covered employees and family members access to telehealth for years. However, the acceleration to telehealth for both mental and physical health care has exploded during the COVID-19 pandemic.
According to a March 2022 article published by the Kaiser Family Foundation, the utilization of telehealth pre-pandemic was relatively low; it accounted for fewer than one percent of overall outpatient visits. At its peak during the pandemic, telehealth represented 13% of outpatient visits from March to August of 2020. A year later, telehealth had declined to eight percent of overall outpatient care.
For mental health and substance use services, telehealth skyrocketed in 2020 and 2021. It reached a 40% share of outpatient visits in March 2020, declining by less than five percent a year later. Mental health and substance use conditions most frequently treated in March-August 2021 were related to trauma, obsessive-compulsive disorder, bipolar, anxiety, and fear-related conditions, depressive disorders, and disruptive, impulse-control – all at 35% or more of outpatient visits.
Spotlight on Carriers
Humana reports that in February 2020, across the U.S., a few hundred telemedicine appointments were being booked per day. By April of that year, bookings increased to more than one million. The number of U.S. patients who have had at least one telehealth visit has increased 57% since the pandemic, according to a telemedicine study by the Doximity medical network.
Telehealth is a core feature of Kaiser Permanente’s integrated care delivery system. Members have several ways to access virtual care – helping them stay healthier while remaining engaged on the job. Kaiser Permanente offers an Online Symptom Checker, where members can get personalized care advice within a few hours. Members can also get in-the-moment care from a clinician with access to their health record, and no appointment is required. Video and phone visits are available with an appointment. An e-visit gives members the opportunity to complete an online questionnaire and get care from a doctor or nurse within a few hours. Patients can email their doctor’s office with non-urgent questions and get a reply within two business days.
Anthem Blue Cross Blue Shield announced in February a rollout of virtual primary care to plans in Nevada. Eligible members can access a virtual care team that conducts an initial health check-in, creates a personalized care plan, and provides care services to help members improve their health and wellbeing – all at no cost or a low cost.
Through Anthem’s Sydney Health mobile app, eligible members have access to in-app medical text chat for on-demand 24/7 care and scheduled follow-up visits; video-based preventive wellness visits; routine care support services, including new prescriptions and refills, preventive tests, and screening and labs; as well as referrals to in-network, in-person primary care and specialty care when needed.
Anthem Blue Cross members in California have had access to telehealth services for several years.
Like its “Blues” counterparts, Blue Shield of California offers a range of telehealth services to members. Including access to health care professionals online through provider partner websites (like AdventHealth, DignityHealth, MemorialCare, Providence, UCLA Health, and others).
UnitedHealthcare launched a new NavigateNOW virtual-first, level funded health plan in nine markets nationwide last fall. It’s designed to provide members with a personalized virtual care team to provide medical and behavioral health services with a seamless hand-off for in-person treatment when needed. The plan for select employers helps improve health outcomes and create a simpler experience – while also offering members zero-dollar copays for common services, unlimited 24/7 access to care, and reduced plan premiums. While not yet available in California, it is slated to come to 18 additional markets – including Las Vegas – later this year. Through UHC® Virtual Visits, UnitedHealthcare offers its other plan members telehealth services.
Health Net offers telehealth services through many of its plans using Babylon Health. Members can use the Babylon app to make an appointment to speak with a health care provider for non-emergency medical or behavioral health issues. Medical appointments are available 24/7, while behavioral appointments are available weekdays from 7:00 a.m. to 7:00 p.m., Pacific. Depending on the plan selected, telehealth services may also be available through Teladoc.
One of the selling points of Oscar since it launched in 2012 has been its Virtual Primary Care and Virtual Urgent Care services for members. The same is true of plans offered through the Cigna + Oscar partnership. Cigna + Oscar small business health insurance plans allow employers to focus on their businesses, while offering affordable health care to employees. Hundreds of doctors are available on call with a $0 copay, so it’s easy to stay on top of your health and get quality care right from home.
As far as virtual care for regional health plan partners, Sutter Health Plus members can access video visits with select provider or licensed health care clinicians through Sutter Health’s My Health Online. Western Health Advantage offers connections to its medical group partners’ virtual care teams through its website and Teladoc. In San Diego, Sharp Health Plan members can get the care they need though video and phone visits.
For information about telehealth services through Word & Brown’s other Small Group and Large Group Medical carriers, talk with your Word & Brown representative. We offer coverage from more than 20 carriers in California and Nevada, and we’ll work with you to find the plan that best suits the needs of your clients and their employees.
Something to watch for in the future is the expanding footprint of Sana, a health insurance startup that focuses on small businesses that previously could not afford to offer health care to employees. Sana currently offers plans in eight states: Arizona, Illinois, Indiana, Kentucky, Ohio, Oklahoma, Texas, and Virginia. It plans to use recently raised funds to expand in other states. It also offers Dental through Beam and vision through VSP.