Changes in Health Insurance: The Telemedicine Perspective
Amidst the era of lockdowns and social distancing, taking safety precautions for one’s health has been prioritized. This, coupled with further technological advancements, has greatly expanded the telemedicine field. Patients now have the option to access health care services through the comfort of their own homes. Due to this, telemedicine has transformed the world and how healthcare is provided on a global scale.
However, necessary health coverage did not cover these services, but as it is predicted to be a large growth point in the future, insurance companies are slowly adapting to these as well. This write up will shine light on challenges and social security coverage offered to telemedicine patients.
What is Telemedicine?
Telemedicine is when healthcare practitioners are not physically present with the patients, which is where telecommunications technology helps glue the two together. Telemedicine encompasses:
- Video consultations with practitioners to avoid long waiting times, and for diseases that do not require physical interaction.
- Wearable devices that monitor and send live updates of the patients’ vitals.
- Applications that are patient-centric and assist in the management of the health data of the user.
The pandemic greatly emphasized the need of telemedicine which was not only a safe option in dark times, but allowed for doctors to conduct appointments with an endless amount of patients. The advantages which telemedicine offers goes beyond this, especially in the post-covid world.
Reasons Why Telemedicine Should Be Covered
1. Increased Access to Healthcare
- Accessibility of medical services is one of the biggest problems facing patients today. Telemedicine is fast becoming the solution to this problem by allowing patients from all walks of life and regions to interact with medical professionals regardless of the distance. This has revolutionized healthcare and many challenges commonly faced by most patients have been closely addressed.
- Less travel: Patients do not have to forego their busy schedules and travel for long hours to have routine check-ups or a follow-up meeting.
- Telehealth has also lowered the incidence of missed appointments greatly – patients can schedule appointments when it’s safest and most convenient for them. This improves the long-term outlook in terms of health of the average patient (Expert Insurance).
2. Provides Cost Efficient Healthcare Services
- Aside from providing easy access to a variety of healthcare services, telemedicine can also be cost effective for most patients and an insurance company.
- Lower Cost: To save patients money on healthcare out-of-pocket expenditure, many virtual visits have a much lower co-pay than the in person visits.
- Lower Facility Costs: Providers no longer have to pay the high costs associated with having an office which….offers Telemedicine at lower prices
- Long term Care: Considering how expensive emergency visits and hospitalization are, telemedicine tackles that issue by helping care for patients with chronic conditions using regular check-ins (Bajaj Allianz).
3. Enhanced Quality of Care
- Telemedicine improves the quality of services by ensuring the professionals have access to patient information anytime:
- Remote Patient Monitoring (RPM): RPM devices enable health professionals to remotely monitor patient parameters such as blood pressure, glucose levels, and heart rates. This measure of monitoring will pave way for timely attention and control of chronic diseases (EasySend).
- Data-Driven Insights: The linking of telehealth and electronic health records helps telehealth providers to perform their tasks with relevant facts and figures concerning their patients.
4. Improved Mental Health Services
- The concern for mental health needs has attracted focus in several quarters in recent years, and the advent of telemedicine has significantly contributed to increasing the pool of service providers addressing mental health needs.
- Virtual Therapy Sessions: Many insurers now reimburse licensed professionals for virtual therapy visits, making it easier for people to receive care without having to deal with the stigmas associated with going into a clinician’s office (Founder Shield).
- Increased Flexibility: Patients can book appointments according to their schedule easing the pressure for those who are busy or have difficulty in mobility to seek mental health care.
Challenges Facing Telemedicine Coverage
Telemedicine has challenges that hinder its capacity to be accepted and efficient in its use in daily life and these include:
1. Regulatory Hurdles
This is one area that most countries will have some variation from the US as many regions will have laws that are curtailing the use of telehealth practices which can lower the coverage options available. Moreover, laws within many countries on telehealth services have been lacking or have not been revisited, many such variations among counties affect the acceptance and practice of telemedicine.
Licensing Issues: Telemedicine entails consultations of physicians and clients in a different location apart from each other, which may be a different Sate or country. Thus, Providers of healthcare may require licenses to practice in across different states for consultations. Telehealth consultations may also attract different reimbursement policies from insurers compared to actual consultation visits.
Payment Models: Among the many restrictions that center around telemedicine utilization is a lack of reimbursement coverage for telehealth consultations across different health insurers that exist.
2. Technology Barriers
Funding and support has contributed towards the improvement of telemedicine, but not all patients have the same degree of access.
Patients living in rural areas or a low income – It is possible that low income patients or those living in rural areas do not have a reliable internet connection for virtual consultations or the right devices.
Such limitations further compound the access to telehealth for elderly patients who may be more resistant or less conversant with modern technology.
Technologies: It is common to find older adults having difficulties mastering technologies which will pose additional barriers towards accessing telehealth, which does offer additional strategies to enhance healthcare access.
3. Privacy and Security Concerns
There is of course potential concern about data breaches as cyber security is already a big issue in the healthcare sector as it has become an easy target for cyber criminals who are interested in data. What makes matters worse is the fact that privacy and security are essential issues in the provision of telemedicine.
The provision of HIPAA compliant insurance for all telehealth services and platforms has made some strides towards addressing the growing concerns around patient confidentiality and security.
The way forward for telemedicine coverage in health insurance.
As telemedicine becomes more popular, several future developments are shaping its use in health insurance:
1. Greater And Broader Scope Of Coverage
The necessity to include a greater range of telehealth services is been impacted by greater reimbursement from insurers:
Management of Chronic Diseases: Reimbursing remote visits for the management of chronic diseases via telemedicine is looking to go beyond just primary care.
Care Services for Health Concerns: There is an upward trend in inclusion of preventive care services through telemedicine.
2. Combination With Remote Monitoring Devices
The expansion of remote monitoring devices opens up new avenues for the healthcare payer:
Monitors Chronic Conditions Constantly: There are several insurers who are teaming up with manufacturers of wearable devices in order to capture real time data of the insured. Allowing for chronic disease management and tailored care (Founder Shield).
3. The Flexible Features Of Insurance Products
With the introduction of on demand insurance models, consumers have more control over how they manage and consume features of their policy:
Plans with Subscription Models: These plans allow users to turn their coverage on and off as they feel it’s necessary which results in providing them with better control over their health cost.
4. Model for Care Based on Value
It has now become clear that outcomes matter more than volume:
Outcomes-Driven Payments: Insurers have started rewarding providers on the basis of the patient’s outcome rather than the services offered. This view makes sense as every financial consideration is constructive in ensuring quality care is offered (Expert Insurance).
Conclusion Telemedicine has changed the way healthcare is offered by improving accessibility, reducing costs and improving the level of care patients receive. As telemedicine expands, consumers will benefit from cost-effective policies offered by providers that will allow them to manage their health more conveniently.
However, while legislation, technology, and privacy issues are difficulties, emerging telehealth technologies are ready to change the way healthcare is provided and accessed. With new methods, insurers have the best chance of changing the shape of healthcare provided to their clients while retaining the best possible level of quality for the clients.
As we enter the new phase of growth where digital health will dominate, it will be very important for the consumers to know the details of their insurance coverage as this will be imperative for those taking up telemedicine to better understand their choices.