Telemedicine is one great example of why it is so hard to change healthcare in the U.S. In the era of the coronavirus (COVID-19) pandemic, telemedicine utilization has gone from less than 5% of members to over 30%. Providers, facilities, employers and patients have universally agreed that getting care through telemedicine is a no-brainer. It eliminates wasted time and exposure to other patients who might pass along additional illnesses. It is significantly less costly and increases the amount of time providers can spend with patients. And it works. Many conditions do not require a doctor to perform a physical examination. Doctors can even e-prescribe medications, which then can be delivered to the patient’s home. And for conditions like mental health, telemedicine might even be better for a host of reasons including reducing the stigma of going to a provider’s office.

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Viewpoints from Craig Hasday

So why has utilization hovered between 2-3% for those plans that had offered the benefit?

The Health Insurance Portability and Accountability Act (HIPAA) is a good reason. Everyone has FaceTime, Google Duo or any number of video chat programs. Federal regulators, under HIPAA rules, decreed that these platforms are not secure enough for telemedicine. So, providers were forced to use incredibly expensive platforms to deliver this care. COVID-19 forced regulators to ease up on this and allow established secure tools to be used. Problem solved.

State licensing rules are another obstacle. In some states, the provider has to be licensed both in their state and in the state in which services are rendered (i.e. where the patient calls from). This is costly and administratively complex. This also applies to prescribing of medicine in connection with a telemedical visit. Voila – with COVID-19 these issues are relaxed.

Technical issues surrounding billing and credentialing and provider resistance because of the fear of eroding their core practice are other reasons which seemed to be non-issues in the midst of crisis.

In all likelihood, telemedicine as we now know it is here to stay and it will improve healthcare and lower costs. Good for all of us. This will be one positive that comes out of this horror show.

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Craig Hasday

President, National Employee Benefits Practice