Telehealth is living up to its promise of increasing access to quality care and providing significant cost savings to patients and employers, contends Tom Meier, vice president of market solutions at Health Care Service Corporation.
A new HCSC internal analysis of the company’s telehealth program, Virtual Visits, based on data collected in 2017 and 2018, showed that participating group employers saved more than $15 million — which translates to savings of 39 cents per employee per month, Meier says.
Some 85% of HCSC’s members who used Virtual Visits avoided a more expensive care setting, such as urgent care and emergency department visits, with overall medical costs 17% lower for Virtual Visit users than for non-Virtual Visits users. Adjusting for the relatively healthier telehealth population, the actual savings on costs is approximately 1%, Meier says.
For individual members, the out-of-pocket cost for a Virtual Visit was an average of just $18, compared with an average of $64 for an in-person visit, he adds.
Chicago-based HCSC, an independent licensee of the Blue Cross and Blue Shield Association, is the largest customer-owned health insurer in the U.S. and the fourth largest overall, operating through BCBS plans in Illinois, Montana, New Mexico, Oklahoma and Texas.
HCSC launched Virtual Visits in January 2017 — through the program, members can consult with a board-certified doctor at any hour of the day, seven days a week, through a mobile app, online video or phone. More than 8.3 million of HCSC’s 16 million members have the Virtual Visits program available to them, Meier says. The product is available to self-funded, fully insured, and small and large group customers.
How was the Virtual Visits program received by members?
Meier: The program was well received by our members. During the first two years since the program was launched, 122,000 HCSC members had 181,000 virtual consultations. The overall satisfaction rate was 90 percent.
Our participating employer groups were pleased that we were offering a product that could help keep their employees happier, healthier and on the job. They also saved money when their employees took advantage of Virtual Visits for mild conditions instead of going to pricier urgent care or emergency rooms.
In addition to savings, what are some of the other key findings from the study?
Meier: Virtual Visits users' interest and engagement are growing. The most common conditions cited for Virtual Visits were cold, flu and infection-related, relatively mild health issues that can easily be resolved without an in-person physician or emergency room visit.
The majority of Virtual Visits (67%) resulted in prescriptions being issued, most typically for antibiotics, helping patients feel better quickly.
Do you have statistics on the program’s usage showing its growth?
Meier: In just the first two years of the program, we witnessed a 36% uptick in usage. We are seeing growth in the number of repeat users as well.
Who uses Virtual Visit?
Meier: To date, the Virtual Visits product is being most used by fairly healthy Caucasian women in their 30s who live in urban areas, accounting for 70% of users. The rest of the users included Hispanic at 12%, African Americans at 7%, Asians at 2% and about 6% were of unknown ethnicity.
In addition to demographics, it is also interesting to note the time of day when there are the most frequent users of Virtual Visits. Approximately 75% of Virtual Visit consultations occurred between 6 a.m. and 6 p.m.
What are the top health conditions Virtual Visits’ physicians treated?
Meier: In 2018, the top five conditions Virtual Visits reported were acute sinusitis (15.3%), acute upper respiratory infection (9.9%), urinary tract infection (4.3%), acute bronchitis (4.2%) and acute pharyngitis (3.9%). The majority (67%) of Virtual Visits result in prescriptions being issued, most typically for antibiotics.
How is patient satisfaction?
Meier: Members who participated in Virtual Visits had an overall satisfaction rate of 90%. The average wait time for a virtual visit is just 10 minutes, with 50% of our members being connected to a doctor within five minutes of making their call.
An uptick in repeat users — from 1.3 visits for each user in 2017 to 1.4 visits in 2018 — tells us that our members are finding value in these visits.
What were the challenges in getting the program started?
Meier: Identifying the right telehealth provider partners was integral to the program’s success. We worked closely with our telehealth partners to build a program that offered our members personalized and convenient care.
How does HCSC plan to expand or improve the program in the future?
Meier: While we are pleased with the early participation and feedback from our members, HCSC will focus on encouraging more members to try it for the first time, particularly those who live in low-income rural areas. To do so, we will continue to segment and increase our marketing efforts to reach them. We will also provide additional educational materials to our employer groups that they can share with their employees to help them better understand the benefits of the program. Our goal is to increase our utilization rate to 10% by 2020.
Additionally, HCSC will include the telehealth program in its antimicrobial stewardship efforts. This program can help high prescribers of antibiotics be more aware of their prescribing rate compared to their peers and it offers recommendations how they may alter their prescribing protocols.
