Employers expect to boost virtual care offerings, survey finds | Healthcare Dive

Large employers expect to pay more than $15,500 per employee for health coverage next year, 5.3% higher than the $14,769 expected this year, according to an annual survey from nonprofit Business Group on Health. That's slightly up from the 5% increase employers estimated in each of the previous five years. 

Employers are increasingly welcoming virtual care options. About 80% of respondents said they believe telehealth will play a significant role in how care is delivered in the future, compared with 64% in 2019 and 52% in 2018. More than half said they will offer more virtual care to employees next year.

Employers also plan to expand access to virtual mental health and emotional well-being services. More than 90% said they will offer telemental health services, and 54% plan to lower or waive those costs in 2021.


Six months into the pandemic, insurance companies are reporting record profits as Americans continue delaying routine in-person care. Many have turned to telehealth services or stopped receiving preventive and elective care altogether, making the exact cost employers will pay for workers' health coverage "a moving target" over the next few years, Ellen Kelsay, president, and CEO of the group said.

While the increased costs of treating pandemic patients, the. the pandemic caused patients to defer routine care, or even see their physician for possibly serious conditions, such as chest pain. After the acute wave of. coronavirus emergency visits, emergency rooms became empty. Patients are still wary of hospitals and doctors' offices.

In-person doctor visits plummeted during the start of the COVID-19 crisis in the United States, but have rebounded to a rate somewhat below pre-pandemic levels, according to a new analysis issued by The Commonwealth Fund and conducted by researchers from Harvard Medical School, Harvard University and the life sciences firm Phreesia.

According to data compiled through Aug. 1, all physician visits were down 9% from pre-pandemic levels. That's significantly improved compared to data from late March when visits were down 58%. Although the rebound got major traction beginning in late April, it began plateauing in early June, when all visits were 13% lower than normal. As of early August, in-person visits were down 16% compared to pre-COVID levels. States that are currently coronavirus hot spots are seeing bigger declines than states where the case levels are lower.
Meanwhile, telemedicine encounters have settled in at rates much higher than pre-pandemic levels. However, they still make up just a fraction of patient-provider encounters for care. As of the start of this month, they comprised 7.8% of all such encounters. That's compared to a peak of 13.8% in the latter part of April. Prior to COVID-19, they were only 0.1% of all visits.

On another note:

The use of telehealth services has skyrocketed since the Trump administration broke down regulatory barriers to access early into the pandemic.

In the week ended March 7, only 11,000 elderly and disabled Americans in Medicare used telehealth. By the week ended April 25, that had snowballed to 1.7 million Medicare beneficiaries.

But providers who invested heavily in those services and the companies that furnish them are dependent on those regulations to make or break future use.

AHA said it was pleased with President Donald Trump's Aug. 3 executive order to improve telehealth access in rural communities through a new payment model for rural hospitals and accountable care organizations that will use upfront and capitated payments.

And while CMS' 2021 physician fee schedule draft also released earlier this month offers additional telehealth flexibilities, it's still not enough to ensure continued virtual care access, according to the hospital lobby.

CMS' proposal notably excluded payment for audio-only telehealth visits, which AHA strongly recommends it provide.

AHA also recommends allowing annual beneficiary consent to virtual treatment to be obtained at the same time, not necessarily before, services are provided. Hospitals should retain the ability to capture diagnoses impacting risk adjustment scores through telehealth visits too, according to AHA.

The 2021 PFS proposal does include the permanent addition of nine new telehealth codes, and 13 will be covered through the calendar year in which the public health emergency ends, to give physicians a chance to deliver services virtually before CMS decides whether to permanently allow them.

Other proposed changes from CMS include allowing Medicare providers to conduct evaluation and management home visits for established patients virtually, allow an emergency room E/M virtual visit for minor to moderately severe health issues and expand some telehealth services similar to those already covered by Medicare, like for group psychotherapy or care for patients with cognitive impairment.

The administration has viewed telehealth favorably, launching a pledge to "Embrace Technology to Advance America’s Health" on Wednesday in an effort to "reassure patients, providers, and payers that telehealth is here to stay and will be covered over the long term."

The pledge calls on commercial insurers to commit to expanding flexible and affordable telehealth options, and on providers to accelerate the adoption of telehealth services, though it's still unclear exactly how far CMS will go to help facilitate those expansions long-term.

Employers expect to boost virtual care offerings, survey finds | Healthcare Dive