HIU: They Healthhealth Should Be Part of Every Cost-Containment Strategy
hiu-digital.com | HIU 49
treatment for minor conditions, resulting
in lost productivity and unnecessary costs
for themselves and/or their employers. As
for doctors, they may be forced to rush
them through their ofces in order to keep
up with the increased demand.
What about afer hours?We expect to
see an increasing number of individuals
going to urgent care clinics and ERs if
they can’t get in to see a doctor, resulting
in even greater costs.
Te American Medical Association
states that 70% of doctor’s ofce visits can
be handled over the phone and 50% of ER
visits are non emergencies. Telehealth’s
savings in claim costs range from $300 per
year for a single employee or more than
$1,000 per year for a family of four.1
Te bottom line is clear:Te healthcare
industry has changed and it will contin
ue to become more antiquated, inefcient
and costly unless there is change. It’s the
perfect storm for innovative solutions.
According to TowersWatson: “Over the
next fve years…nearly half the employ
ers expect a signifcant or transformative
change. More specifcally, 49% expect
more healthcare price transparency and
45% expect to see new access points for
healthcare delivery, such as telemedicine,
e visits and data enabled kiosks.”2
A SENSIBLE SOLUTION THAT IS
Te telehealth industry, as it relates to
individuals and the workplace, has been in
development for more than 12 years, fne
tuning itself to deliver quality care when
and where it’s needed. Currently, there are
close to 8 million individuals with tele
health benefts paid for by their employer.
Companies such as Accenture,Te Home
Depot, Amazon, Metro PCS, AT&T, Penske,
CalPERS and some insurance companies
have been ofering telehealth.
Why is telehealth gaining so momen
tum? It addresses the three biggest issues
in healthcare today:
• Timely Access
• Lower Costs
• Quality Care
Te established telehealth providers
ofer access to experienced, licensed,
board certifed physicians 24 hours a day,
seven days a week. If individuals have a
minor illness, they can talk to a doctor
by phone or online, receive a diagnosis
and treatment, including a prescription if
needed, all within an hour. Minor health
• Stomach ache
• Respiratory infection
• Urinary tract infection
• Pink eye
• Ear infection
Te doctors from the established tele
health frms typically derive from primary
care, internal medicine, emergency room
or pediatric practices, with an average
of 15 years experience.Tey have been
thoroughly vetted and have undergone
extensive peer reviews and the full creden
Most of them are practicing physicians,
like your own family doctor, and dedicate
extra time for these consultations.
Some programs ofer more expanded
services, such as access to specialists who
respond to medical questions via email,
ofen sending links to articles and videos
designed to educate consumers and help
them manage their health.
It is essential to understand that tele
health is not meant to replace primary
care physicians. In fact, telehealth doctors
encourage patients to see their doctor and
get their wellness exams and lab work
completed.Tey can even send their tel
ephonic or online consult records directly
to the patient’s physician.Tey simply
provide an efcient and cost efective
solution for those with minor health
conditions who can’t get to a doctor in a
It’s a win for all. Individuals save time
and money. Employers can see tremen
dous reductions in absenteeism, leading
to increased productivity. Self funded
companies can see immediate savings to
their bottom line.
According to Absenteeism:Te Bottom
Line Killer, a publication of workforce
solution company Circadian, unscheduled
absenteeism costs roughly $3,600 per year
for each hourly worker and $2,650 each
year for salaried employees.
Te Gallup HealthwaysWell Being
Index surveyed 94,000 workers across 14
major occupations in the U.S. Of the 77%
of workers who ft the survey’s defnition of
having a chronic health condition (asthma,
cancer, depression, diabetes, heart attack,
high blood pressure, high cholesterol or
obesity), the total annual costs related to
lost productivity totaled $84 billion.3
Typical results from a prominent tele
health frm from 2013 showed the following:
• 125,000 medical consults
• 91% of patient issues resolved
• 97% member satisfaction rating
• Average wait time: 24 minutes
• Redirection of care:
• 43% would have gone to doctor
• 34% would have used an urgent care
• 8% would have visited the ER
When factoring in the costs saved by
redirecting care and keeping the employee
at work, our calculations show that each
call to a telehealth doctor will save an
employer close to $240.4
When you look at the math, the num
bers are staggering.
If it’s really that efective, some people
may inquire:Ten why isn’t everyone
using telehealth as part of their cost
containment strategy? It’s a good question.
Te answer is quite simple:Te potential
for these results is clearly evident, but the
actual results are based on utilization,
which has garnered lower results.
Tere are several reasons utilization has
not met expectations.Te frst is that most
50 HIU | hiu-digital.com
telehealth providers sell “access” to their
service at a low fee and then charge $35 $40
to the employee for the medical consult.
Te problem here is telehealth is still
a new technology and employees seem
reluctant to pay for a phone consult when
they don’t quite understand the beneft.
Tis brings up the other problem,
which is educating the employee about
telehealth what is it and how to use it.
In years to come, as telehealth becomes
as mainstream as social media, individuals
may not mind paying $35 or more to get
immediate access to a doctor by phone, es
pecially if they have a high deductible plan
and/or don’t have the time to visit a doctor.
But, today, that isn’t the case. Telehealth is
still relatively unknown to most individu
als, not to mention to most employers.
What is needed today to make a tele
health beneft a success story is simple.
It’s the same thing all corporate wellness
directors have attempted for the last 25
years. It’s all about changing behavior.
It is far more difcult to change be
havior when trying to get employees to
change their diets and go to the gym. It
isn’t so difcult to change behavior when
introducing a telehealth beneft.
• Te frst thing to do is change the busi
ness model. Build the doctor’s fee in
to the monthly cost of the program so
employees don’t have to pay anything to
call a doctor. Eliminate the barrier.What
do they have to lose?
• Create an awareness building campaign
that includes regular monthly remind
ers what is telehealth, when should it be
used, what conditions can it treat, how to
access a doctor, seasonal reminders/tips
for fu season, allergy season, summer
vacations, etc.Tose who hear about
it during open enrollment without any
follow up have long forgotten they even
have the beneft by the time they need it
several months later. It has to be the frst
thing they think about when they get sick.
• Encourage employees to share their
experiences with telehealth via internal
communication materials.Te more peo
ple who use it, the more they understand
the efciency and low cost, the more
likely they are to talk about the benefts
and remind others of the program. It is
simple for the service to gain traction in
the workplace by word of mouth.
Healthcare has changed and will con
tinue to do so. Companies will continue
to grapple with the question of what is
best for the company and what is best
for the employee. Self funded companies
will look for innovative solutions that can
have an immediate and long term impact.
For fully insured companies, there will be
changes that will result in higher deduct
ibles and many that result in employees
being told to select their own health plans.
In all cases, telehealth is a solution. Im
mediate access to care by phone or online
saves time and money and allows those
who need care the most to get in to see a
doctor. Individuals can easily save hun
dreds, if not thousands, of dollars a year
in out of pocket costs. Companies cannot
only manage healthcare costs far better,
but they can also decrease absenteeism
and increase productivity a goal they
have been working on for the last 30 years.
It’s not the future. It’s here today. HIU
1 Schultz, R. (2012, January 09). New medical
cost savings program: Telemedicine means great
2 Employers Plan Aggressive Response to Shifing
Health Care Landscape, TowersWatson/Na
tional Business Group on Health Survey Finds.
(2013, March 07).
3 Te Causes and Costs of Absenteeism in the
Workplace. (2013, July 10).
4 Based on the following assumptions: PCP visit
$122, urgent care visit $152, ER visit $752,
time missed from work four hours @ $21.74