Highmark: Insurers should embrace telemedicine
FHP: What should insurers keep in mind when deciding to partner with a telemedicine vendor?
Fischer: There are a number of parameters you must take into account. Most importantly, look at the technology. Make sure it satisfies standards.You must have a system that adheres to privacy standards and one that can produce high quality images.
There aren't a lot of systems out there right now that can do what we want them to do. But down the road, I think this will change. Health plans definitely can help move the market.
Several years ago, only a few vendors would meet these standards. Then, suddenly, there were double the number of vendors.
It's multi-factoral. You need the right technology that is relatively easy to use and the provider must embrace change. If that provider is stuck in a certain methodology and thinks that the only way to go is an in-person doctor visit, then that's a huge barrier. Overall, the patient has to feel comfortable. Everything must align--the standard of both provider and insurer. I think we're still scratching the surface.
FHP: How can an insurer successfully incorporate telemedicine into their plan?
Fischer: There are a lot of policies and benefits that won't pay for anything but a face-to-face visit. There are some benefits out there that the insurer will pay and some that they insurer will pay only a certain amount per year for services that are medically necessary. We believe telemedicine should happen. But it's hard because we wonder how much we'll pay for telemedicine. Will our claims go through the roof because we decided to cover this? It's all about making sure you can tackle these barriers to incorporate the service so that it's cost-effective for everyone.
FHP: What is the biggest challenge insurers face when deciding to cover telemedicine?
Fishcer: There is definitely a stigma to overcome, since telemedicine covered by an insurer is still new, and not many companies are including it. There's obviously the concern about risk and payment abuse, as well as waste. There's definitely internal culture to overcome as well, since this has never been done before. And of course, there's concern about risk of payment and abuse. Then there are the doctors who don't want to offer it, the patients who don't want to use the service and all the regulatory issues that surround it.
For telemedicine to advance, the whole industry needs to be on the same page--we need to spark the right balance.
Comments