Telehealth Coverage Inspires Trust in Health Insurance Plans

Highlights  

• Covid-19 ushered in the need for telehealth coverage for millions of Americans.

• Post-pandemic, most people expect telehealth coverage as part of their healthcare plan.

• Including telehealth services in your health insurance coverage inspires trust in plan members and can lower your healthcare expenses.

• With Roundstone’s self-insurance solution, you have the freedom to design your group captive plan to include telehealth coverage for your employees using the self-insurance model.

In 2020, the need for telehealth coverage grew exponentially, accelerating the new era of digital healthcare. Although telehealth service use has somewhat lessened post pandemic, telehealth coverage remains a critical expectation for most insured Americans. It’s also a great way to save costs while prioritizing quality care that’s convenient to your employees’ schedules.

Including and incentivizing telehealth services into your health insurance plan can help inspire trust in your plan members and save on plan costs over time.

The Rise of  Telehealth Coverage in America

A recent report by the Office of Health Policy looked at survey trends regarding telehealth usage in the past few years. According to a study by FAIR Health, telehealth appointments rose from less than 1% of healthcare visits to as high as 80% during March and April 2020. A 2021 news release reported a 63-fold increase in telehealth visits for Medicare patients between 2019 and 2020.

Although initial reports showed a decrease in telehealth appointments immediately following the peak of the pandemic, newer research indicates that telehealth is here to stay. In 2021, McKinsey & Company reported that patients were using telehealth services at a steady 38 times higher than pre-pandemic levels.

The Kaiser Family Foundation (KFF) Health System Tracker (HST) found that telehealth visits continue to boost outpatient visit numbers. The KFF HST also found that children and those aged 19 to 64 use telehealth services at a higher rate than those over 65.

Does Telehealth Coverage Matter to Insured Employees?

Telehealth coverage continues to be a crucial expectation for insured employees. A 2021 Verint survey found that coverage for telehealth services inspires higher trust and allows access to important services members may not use otherwise, lowering the cost of care while improving quality. Those with access to telehealth services showed a 12% increase in trust in their plan.

The survey results also showed that:

• 69% of plans offered telehealth coverage
• 22% of respondents didn’t know if their plan included telehealth services
• 73% of those who have telehealth coverage and have used it would use the benefit again
• 16% of respondents said mental health coverage was important when choosing a plan, including mental health visits through telehealth platforms

In 2022, a McKinsey & Company survey found that 60% of respondents used telehealth because of convenience, and 55% said that they felt more satisfied with telehealth services over in-person visits.

Why Employers Save with Telehealth Coverage

With spiraling costs of employee health insurance for small to midsize businesses, cutting costs is critical. Offering telehealth coverage to your employees can help gain support and trust, which can increase employee utilization and save you money.

Here’s how.

Better Chronic Health Condition Management

Employees with chronic health conditions like diabetes or kidney disease require ongoing treatment and medication from their primary care provider, specialty clinics, and pharmacy.

The KFF HST found that telehealth is most often used for the management of the following conditions:

• Obesity
• Asthma
• Hypertension
• Diabetes
• Thyroid conditions
• Heart issues
• Arthritis
• Chronic kidney disease

When employees can’t get the care they need, their health suffers and often results in a worsening of their condition or a catastrophic event, which dramatically increases plan costs. Catastrophic claims can devastate your healthcare budget. Offering telehealth services for better chronic condition management upfront can help you avoid this, benefiting your employee and all plan members and saving you money.

Increased Mental Healthcare Access

According to the Verint survey, 44% of Millennials and 66% of Gen Z employees care about having access to mental health services. Behavioral health issues have risen over the last several years, leading to the need for increased access to mental health, especially through virtual tools.

Employees struggling with higher levels of anxiety, depression, and substance use can lead to poor job performance and co-occurring health issues. By offering telehealth coverage for mental health providers and treatment programs, you can support your employees’ behavioral health needs.

This approach can also help you cut costs by ensuring your employees are healthy and happy, which can improve their motivation and efficiency at work and benefit company culture.

Lower Out-of-Pocket and Coinsurance Costs

Telehealth coverage can help lower out-of-pocket costs for your employees and, if implemented correctly, cut expenses from your overall healthcare plan. With a self-funded insurance plan, you can set co-pays for telehealth appointments, keeping them affordable so all employees can access the care they need.

While costs for employers vary based on telehealth providers and services, many sources have found that telehealth visits dramatically lower healthcare spending for employers, especially in a self-funded insurance plan. This is especially true when you avoid more expensive encounters like emergency room visits, which can cost an average of $1,734 for non-life-threatening complaints.

Incentivization of Less Costly Health Interventions: An Advantage to Self-Funded Insurance

Implementing telehealth coverage in your health plan can incentivize your employees to avoid more expensive health interventions, such as emergency departments and urgent care. This can save your company substantially if you utilize self-funded health insurance using the group captive model.

Urgent case usage has spiked, thanks to convenient locations in retail pharmacies and in urgent care centers. However, urgent care costs employers much more than primary care or telehealth visits.

In a self-insured plan, you can steer employees away from unnecessary urgent care visits by offering telehealth access to PCPs or specialists and incentivizing them with low co-pays. This approach can help them access appropriate care quickly and conveniently and minimize the use of high-cost alternatives.

Roundstone’s Self-Insurance Makes It Easy to Incentivize Telehealth Services

Roundstone’s group captive self-funded insurance plans make it easy to include and incentivize telehealth services for your employees. With Roundstone, you have the freedom to design self-funded health insurance for your company, including vendors, providers, third-party administrators, and pharmacy benefits managers.

You can work with your very own CSI Team and benefits advisor, who will examine your members’ needs and help you write a customized Summary Plan Description (SPD). You can include telehealth coverages for PCPs, specialists, and mental health professionals to build trust with your employees and create a culture of positivity and respect.

With Roundstone’s approach to self-funded insurance, you also have access to our CSI Dashboard, a digital claims analytics feature that shows your claims data in real-time. This provides valuable information you can use to save money while improving employee access to quality care. With guidance from your CSI Team, you can gain spending insights and make changes to your self-insured plan to incentivize telehealth utilization and cut costs for all plan members.

Include Telehealth Coverage in Your Self-Funded Group Captive Plan with Roundstone

Boost health insurance benefits for your employees with cost-effective telehealth coverage through Roundstone’s group captive self-funded insurance. You can build your plan to include low co-pays for telehealth over more costly urgent care or ER visits and support your employees in managing their mental health.

Your employees deserve access to quality care. Telehealth coverage can be a critical component to care accessibility.

Contact a Roundstone advisor today to discuss your company’s health insurance needs and how we can help you lower your healthcare expenses through a self-funded insurance solution.