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Survey Finds Big Business is Refining its Telehealth Benefits

The latest National Business Group on Health survey finds that large employers are identifying and meeting the specific telehealth needs of their employees, such as telemental health.

Source: ThinkStock

By Eric Wicklund

- The latest survey on big business and healthcare finds that they’re moving from making telehealth a benefit to finding specific uses for the new service.

As with last year’s survey, the “Large Employers’ 2018 Health Care Strategy and Plan Design Survey,” put out by the National Business Group on Health, finds that almost all large employers are expected to have a telehealth benefit in place for their employees by the end of 2018. If anything, adoption is faster than expected: Last year’s survey predicted that “virtually all respondents” would have telehealth by 2020.

More striking is the number of employers who have moved from offering a simple telehealth platform to making sure that platform features telemental health. This year’s survey stands at 56 percent for 2018, more than double the percentage of employers who offer that specialty this year.

The organization behind the survey says employers are compelled to act by a continuing increase in pharmacy and medical costs for employees: For the fifth straight year, those costs are expected to increase 5 percent, moving the annual price tag for healthcare costs for one employee from $13,482 this year to $14,156 in 2018.

“Employers are recognizing that traditional cost control techniques alone aren’t able to reduce costs to the point where they are no longer a drain on the bottom line,” Brian Marcotte, president and CEO of the NBGH, said in a press release issued alongside the survey. “While employers continue to address costs through healthcare management and plan design efforts, they are also ramping up efforts to positively affect the supply side of the healthcare system by pursuing healthcare payment and delivery reform initiatives.”   

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The survey echoes a Willis Towers Watson survey released earlier this month, which found that that 78 percent of employers are encouraging their employees to use telemedicine to replace expensive office or clinic visits, and another 16 percent are planning or considering that telehealth option by 2019.

That survey also found that, despite rising healthcare costs, 92 percent are “very confident” they’ll continue to sponsor health benefits in five years, a percentage not seen since before the passage of the Affordable Care Act in 2010. This may be a sign that employers are confident they’ll be able to use telehealth and mHealth to curb those rising costs and keep their employees happy.

What the NGBH report finds is that large employers are moving to the next stage – identifying specific high-cost needs, such as behavioral health services – and directing benefits toward them. According to the NGBH, some 80 percent of employers identified “inappropriate use and abuse” of opioids as an area of particular concern.

“While telehealth has shown a breakneck growth, more than doubling itself year over year for quite some time, behavioral telehealth has shown an even more astounding growth rate due to three simple reasons,” Roy Schoenberg, CEO of American Well, one of the leaders in the direct-to-consumer telehealth ecosystem, told Forbes. “Access to behavioral services is even more challenging than access to medical care, the conversational nature of behavioral services makes video encounters perfect alternative to physical ones and the notion of privacy couldn’t be better addressed when you have the encounter in your own home.”

And while supporters and critics alike have long lamented that that percentage of businesses offering telehealth is far above the percentage of employees actually using the service, the NGBH study did find that employee use is rising. According to its survey of 148 large employers, employee use of telehealth is at 8 percent or higher in one-fifth of those companies.

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This, again, may be because employers are moving from offering a generic telehealth platform to finding out what their employees need, or giving them the tools to make better decisions.

“Employers continue to look for opportunities where they can have a positive influence and impact on the healthcare delivered to employees and their families,” last year’s report pointed out. “In just five years, telehealth has gone from a niche program to a service that nearly all employers offer.” 

“One of the most interesting findings from the survey is that employers are focused on enhancing the employee experience,” Marcotte said in the preamble to this year’s report. “For example, there is a big increase in the number of employers offering decision support, concierge services and tools to help employees navigate the healthcare system. The complexity of the system and proliferation of new entrants has made it difficult for employees to fully understand their benefit programs, treatment options and where to go for care.”

One avenue for growth is in value-based benefit design. The survey notes that large employers aren’t jumping on the bandwagon in big numbers just yet, but nearly half have incorporated some aspects in their benefit plan. Some 18 percent have added telehealth, up from 16 percent last year, while roughly 15 percent include chronic care medication adherence or participation in a disease management program – two factors in which mHealth and telehealth have proven to make a measurable difference.

At any rate, telehealth adoption is moving rapidly in the business community. This year’s NGBH survey indicated 96 percent will make telehealth services available in states that support the technology by the end of 2018. The 2016 survey saw 70 percent of large employers planning on giving their employees the option of accessing healthcare online by 2016, up from 48 percent in 2015. And back in 2012, only 7 percent of employers were offering telehealth.

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