Not too long ago, health plans were still sorting out whether they wanted to cover telehealth visits at all. Now, many health insurers are not only covering such services, but increasingly often, aren’t imposing co-pays on consumers who choose to use them.
It’s difficult to know exactly how many plans offer “free” telehealth, given the variety of benefit plans, payers, and insurance products available in the U.S., but examples keep coming into my inbox. Some free telehealth efforts involve huge numbers of beneficiaries, and some relatively few. Some plans have made big announcements about their telehealth co-pay strategy and others have just fallen into place with little fanfare.
For example, late last year UnitedHealthcare said it was rolling out a new virtual care app giving the more than 27 million beneficiaries in its employer-sponsored health plans to access virtual care. Access to such services will be free for most people enrolled in employer plans.
Meanwhile, in a move affecting far fewer consumers, this week a Louisiana-based managed care organization known as Healthy Blue announced that its Medicaid beneficiaries can now access medical and behavioral health providers via telehealth at no cost.
I’m also aware that my own health plan, Kaiser Permanente, offers copay-free telehealth visits, and in fact seems to encourage members like myself to take advantage of them, though to my knowledge it never touted this fact to the media.
In theory, this approach flies in the face of the assumption that co-pays provide that infamous “skin in the game” needed to slow consumer consumption of healthcare services. But that assumption ever reflected reality, apparently, it’s not proving to be the case where telehealth is concerned.
In the past (see my article from early 2019) I’ve vigorously disputed the notion that consumers can somehow automagically lower healthcare prices by asking consumers to pay most of their day-to-day healthcare costs, and nothing has arisen to change my mind. If there’s a study which has demonstrated concretely that this effect even can be induced, I haven’t seen it.
While the insurers who brought us $15,000-per-family deductibles aren’t likely to stand up and admit it, these exercises in offering no-cost telemedicine are concessions that making care easier to access has not only medical but financial benefits. Gee, maybe if consumers have affordable access to care, they’ll stay healthier and reduce overall health plan spending. Who would’ve thunk it? The folks who created, uh, managed care plans?
Of course, part of the reason this compromise Is possible is that with the emergence of mature enterprise-class telehealth services, it’s become more cost-effective in many cases to deliver care virtually. If that’s true, then health plans have every reason to divert patients to face-to-face care only when telehealth won’t work.
Still, in theory, patients could also overconsume telehealth services too if there’s no co-pay or deductible standing in their way. The fact that health plans are promoting no-cost telehealth to patients suggests that such fears are overblown at best – both on- and off-line.