Maintaining the Rapid Adoption of Telehealth after COVID-19

COVID-19 set the stage for the rapid adoption of Telehealth services. It’s estimated that these services will soar to more than 1 billion in 2020, including 900 million visits related to COVID-19, according to Forrester Research.

UnitedHealthcare acted quickly at the beginning of the pandemic and expanded access to Telehealth for health plan members, including waiving member cost-sharing, expanding networks and taking advantage of regulatory flexibility from the Centers for Medicare & Medicaid Services (CMS). The company experienced almost 3 times as many Telehealth visits in the first 4 months of 2020 versus all of 2019.

UnitedHealthcare experienced almost 3 times as many Telehealth visits in the first 4 months of 2020 versus all of 2019.

- UnitedHealthcare Clinical Services Population Health Management

Now, employees and their families continue to use Telehealth for the convenience: the ability to save time with appointments from the comfort of their homes

“The pandemic removed unnecessary barriers to push us into this new Telehealth reality,” says Jean-Francois Beaule, Executive Vice President of Design and Innovation, UnitedHealth Group, the parent company to UnitedHealthcare. “These technologies are proving to be of greater value, and we are rapidly improving the experience based on provider and member feedback. In many aspects, the pandemic has opened our eyes.”

Expanding Access to Care

The push toward increased Telehealth access may continue through virtual appointments in primary care, urgent care, disease management and behavioral health services. Telehealth is the ability to visit with a local care physician via video, audio, or both. Recently, UnitedHealthcare made physical, occupational and speech therapies available through Telehealth capabilities.

UnitedHealthcare data shows that telehealth may be making inroads with certain harder-to-reach demographics, such as rural patients and seniors.  Offering the option of virtual appointments may also increase access to behavioral health services — one of the fastest-growing uses of Telehealth even before the pandemic.

“Social-distancing measures may have further pushed providers and members hesitant to adopt the technology to try it. We may continue to see a rise in behavioral health needs, and we hope receiving care virtually will be part of the new norm,” says Stacie Grassmuck, Director of Health and Behavioral Product & Innovation, UnitedHealthcare Employer & Individual.

Talkspace, a part of Optum Behavioral Health’s Telehealth network, reported web traffic doubled in the past 3 months.

“Telemedicine provides an additional avenue to seek care,” Grassmuck says. “The ability to have appointments in the privacy of your home may help with the stigma. I recommend Telehealth to employers because it opens it up to employees who may not usually seek care. It may be important for employers to be proactive in reaching out to employees to help reduce the stigma of seeking care for their mental health needs.”

“The ability to have appointments in the privacy of your home may help with the stigma. I recommend telehealth to employers because it may open it up to employees who usually would not seek care."

- Stacie Grassmuck, UnitedHealthcare Employer & Individual

In addition, Telehealth may play a beneficial role when a physical examination may not be a large part of an appointment. In some cases, an initial in-person examination may lead to follow-up appointments through virtual care.

“After starting a new medication, a screening may take place over a virtual appointment. That’s a great place to do it. It might open up tremendous possibilities,” says Dr. Gerald Hautman, Chief Medical Officer, UnitedHealthcare National Accounts. “Rural patients meeting with specialists such as a pulmonologist may follow up during the year virtually and coordinate with a local primary care doctor if a physical exam is needed.”

Convenience and Cost Savings

The convenience and cost savings that may be associated with Telehealth have been primary value propositions. Yet use did not pick up steam, until COVID-19 hit.  Since then, UnitedHealthcare has spent considerable time rolling out Telehealth options and encouraging engagement with its Virtual Visits product.

A Virtual Visit is the ability to see a doctor with one of UnitedHealthcare’s national providers — Teladoc®, Amwell® and Doctor On Demand™ — for low-acuity urgent care needs 24/7 such as rashes and urinary tract infections.

“The company is up more than 100% of visit volume year to date compared to this time in 2019,” said Pat Keran, Vice President of Product and Innovation, UnitedHealthcare. “There was over 200% of the Virtual Visits volume alone in April 2020, compared to April 2019.”

UnitedHealthcare  estimates that 25% of emergency room issues may have been diagnosed and treated through Virtual Visits.  A Virtual Visit can on average cost less than $50 a session compared to the $1,800 average cost of an emergency room treatment, and such visits may  offer more convenient access when clinics and urgent care facilities are closed.  Along with the potential cost savings, employers may also see an increase in productivity.

“There are significant cost savings in avoiding ER usage, and services like Virtual Visits have been available as a benefit for many plans, and it’s not limited to this time frame. Awareness among employees may be a big obstacle here,” Keran says. “Instead of taking a half day off from work to see the doctor and possibly be exposed to other ailments, a member might visit a doctor from their chosen location to take care of their health concerns.  The employee and the employer may benefit.”

Employers may consider a dedicated space for virtual appointments in the workplace to encourage engagement and a focus on personal care and wellness.

The Future of Telehealth

Recently, CMS said action from Congress will ultimately be needed to permanently expand telemedicine on a national basis, as existing laws limit coverage to people living in rural areas where access to care is particularly strained.

And the federal agency is evaluating ways to preserve access to telemedicine visits in settings such as patients’ homes, hospice care, and nursing homes. CMS is also considering ways to permanently broaden the types of services that can be provided via telemedicine, such as emergency care, physical therapy and mental health consultations.

“Member accessibility to quality care is core criteria we take to heart. The evolution of Telehealth now being an accepted channel to care may bring access to quality care in a very convenient way,” Keran says.