How Employers Are Accelerating Virtual Care, Telehealth Adoption

Employers are emphasizing virtual care and telehealth in their healthcare benefit and care delivery strategies during the coronavirus pandemic, a recent survey by the Business Group on Health revealed.

The organization conducted an online survey of 122 large employers who cover over 9 million lives.

“COVID-19 had a significant impact on employers’ perspectives on health, helping to strengthen the link between health care strategy and workforce strategy,” the report found. “It also affected planning for 2021.”

As companies manage the pandemic’s unpredictable influence over the work environment—particularly the high uncertainty around healthcare costs and budgeting—many employers have not changed their strategic priorities but, rather, have increased their focus and efforts.

“Many employers haven't necessarily changed their strategic priorities. If anything, they've doubled-down and have been heightened related to their strategic priorities,” Ellen Kelsay, president and chief executive officer of Business Group on Health, told HealthPayerIntelligence and other media outlets on a press call.

Virtual care and mental health were two of the major priorities on which employers doubled-down their efforts, Kelsay shared.

For the third year in a row, implementing more care virtual care solutions is the top priority for employers.

However, unlike the past three years, this year the pandemic tested employers’ virtual care capabilities and forced them to adjust to digital healthcare solutions faster than anticipated.

Whereas barely more than half of large employers believed in virtual care’s influential presence for the future of healthcare delivery (52 percent) in 2018, now eight in ten large employers agree that virtual care will have a significant role in healthcare delivery.

Critically, this rising percentage indicated a long-term view of virtual care usage.

“There's certainly no doubt that virtual care is here to stay,” Kelsay confirmed. “We've already seen significant traction in the virtual landscape for the past several years, and coronavirus has done nothing but accelerate that. We've seen an explosion of investment and resourcing from employers related to deploying more virtual solutions to their workforce.”

As a result, over three-quarters of employers (76 percent) are expanding virtual care solutions and 71 percent are accelerating telehealth and virtual care offerings. Almost seven in ten employers waived telehealth costs due to the pandemic and five percent already did not charge employees for telehealth services.

Naturally, some employers were able to build on existing virtual care offerings and others were new to the virtual care space when they adjusted to the coronavirus restrictions. But just because an employer already had a virtual care platform does not mean employees were engaging with it.

Seventy-eight percent of employers saw increases in virtual care utilization. Telehealth utilization also soared. Blue Cross Blue Shield Tennessee has reported that its telehealth claims hit 50-times their normal amount by May 2020.

Certain conditions are seeing higher telehealth usage than usual. From 2019 to 2023, employers expect musculoskeletal care management in particular will see the largest growth in virtual care services.

One issue that remains unsettled is reimbursement parity.

“We believe that employers should have the flexibility to design that based on what they think is appropriate for their plans,” Kelsay said in the press call.

“We want to be careful that virtual does not overlay additional costs onto an already challenging healthcare cost infrastructure. So making sure that these virtual models are deployed in a value based arrangement is going to be really important.”

Virtual care and telehealth are also helping employers tackle their second highest priority: mental healthcare.

Expanding low to no-cost virtual care is the top way that employers are planning to provide mental health access for 2021, with 54 percent intending to offer zero or low-cost virtual telemental health counseling to employees.

In contrast, exactly half of that number are expecting to give employees access to zero to low-cost on-site mental health counselors (27 percent).

In tandem with these strategies, employers intend to work with their health plan to expand mental health networks (45 percent) and cover out-of-network mental health and substance use disorder (17 percent) in 2021.

As employers continue to grow their virtual care offerings during the coronavirus pandemic, partnerships with payers could play into their decision-making process.

Employers have already shown a willingness to collaborate with their health plans in response to the crisis. Over sixty percent of employers said that they would partner with their payer when moving employees back to the office space, a recent Optum survey revealed.

Payers have been responding to employers’ concentrated attention on virtual care by adapting health plans. For example, Oscar Health now offers free virtual care and telehealth to eligible members.

Alignment Healthcare intends to start a virtual plan that serves Medicare Advantage members and five markets, pending regulatory approval in 2021. The plan would offer concierge-style care and services and incentivizes members to turn to virtual care solutions when appropriate for their treatment.

That being said, the Business Group on Health survey found that fewer employers reported that they were looking to payers and other healthcare partners for direction as they strategize around certain priorities, specifically delivery reform.

Whereas in 2019, 41 percent of employers said that they would defer to health plans and pharmacy benefits managers on how to adjust their delivery models, about half that percentage reported taking that approach in 2020.

Instead, a growing number of employers (24 percent) are taking the steering wheel on delivery reform and using virtual care and digital solutions to bypass the traditional delivery system altogether. Another thirty percent are combining this strategy with efforts to pursue alternative payment models and care delivery strategies independently.

Updated 8/21/20: This article has been updated to reflect that Alignment Healthcare has not yet started its virtual plan, which will go into effect in 2021 pending approval. A previous version spoke of the launch in past tense.