Analysts and consultants have highlighted virtual care as an important trend for the future of healthcare delivery in the U.S. Leading organizations such as Amazon are expanding pilots of telehealth: The e-commerce giant announced last month it would provide increased access to live chat or video services with a physician or nurse practitioner to employees at its Seattle headquarters and their families.
Now, the tech faces another potential moment to prove its value: the emergence of the new coronavirus and COVID-19, the illness it causes. With news this week that the World Health Organization has characterized COVID-19 as a "pandemic" and that total cases of the disease in the U.S. are approaching 1,000 (at the time of publication), telehealth, virtual care and related benefits could serve as "an effective first step in managing the virus," Mary Kay O'Neill, senior consultant, total health management at Mercer, wrote in a February blog post.
Specifically, virtual solutions are useful for assessing and triaging individuals who are concerned about whether they have the disease, O’Neill told HR Dive in an email statement. Those who don't need diagnostic or treatment service can either stay home or be instructed both where to receive services and how to access them without risking additional spread of the disease, while those with a milder form of COVID-19 can be monitored in the home setting, she said.
"Some patients will be able to determine based on a telephonic or video visit that they don't need to get tested, and many will have clinical concerns that have nothing to do with COVID-19," Jeff Levin-Scherz, North American co-leader of Willis Towers Watson's health management practice, told HR Dive in an emailed statement.
Using virtual solutions to determine the need for testing may have a broader positive effect on the healthcare system's response to the disease generally. "If a person needs a test, they can get guidance on where to get the testing done and how to safely interact with the healthcare system so as to diminish the risk of spread if they in fact do not have the disease," O’Neill said. "This also serves to limit overburdening the ER and hospital system with non-emergency care."
But those who believe they do need to be tested should contact their physician's office or local health department, sources noted. "People who need testing will still have to go somewhere to get tested, yes," Steve Wojcik, vice president, public policy at the Business Group on Health, told HR Dive in an emailed statement. "But their first contact with a provider for a testing referral can be through telehealth."
More broadly, virtual solutions can also help with health concerns that aren't related to COVID-19. Those with ongoing care needs not related to the disease can be managed at home or directed to the most appropriate setting for care, O'Neill said, which can help to prevent worsening of other acute or chronic conditions.
Mental and emotional health are two such conditions that sources raised. "This type of an epidemic could also lead to more isolation, loneliness, and emotional needs, which can be addressed through tele-behavioral health," Levin-Scherz said. O'Neill noted that virtual care solutions mean those with behavioral health concerns, whether related to the pandemic or not, "can access help virtually to meet their needs and to decrease the risk of exposure."
Large employers in particular have already lead adoption of virtual care for this purpose. A 2019 BGH survey of members found 73% of respondents had implemented a virtual care solution for mental health and behavioral health, while 9% planned to do so in 2020.
That said, investment in the space hasn't overcome the solutions' low average engagement rates among employees and plan members, sources previously told HR Dive. Many employers are using the opportunity to emphasize the availability of telehealth, including that such solutions generally have lower associated costs and out-of-pocket costs compared to in-office care, Levin-Scherz said.
Employers might also encourage use of such benefits by waving cost-sharing, Levin-Scherz added. Moreover, employees who have access to telehealth benefits can likely access them for free or with minimal copay, Wojcik said.
Benefits administrators should also note recent action affecting high deductible health plans announced by the IRS. "Now with the latest IRS notice allowing the waiving of the need to satisfy the deductible for COVID-19 testing or treatment for those with HSA plan coverage, they too are likely to be able to access telehealth without cost for COVID-19 related reasons," Wojcik said.
Employers should consider that regardless of their approach to virtual care, more people who are not on the priority list for public health authorities will likely seek advice from their own physicians, Wojcik added. But in the meantime, public health authorities including the Centers for Disease Control and Prevention have asked for employers to send sick employees home and to be flexible about telework policies, among other suggestions.
"The most important public health strategy with this epidemic is to diminish transmission by limiting people congregating and spreading the disease," O’Neill said.