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The Benefits of Telemedicine

Is Telemedicine Actually Impacting Your Workers’ Comp Claims?

Telemedicine has become a 'buzzword' in workers' comp. But is it really cutting costs and creating positive results in claims?
By: | July 18, 2018 • 5 min read
women viewing patient via telemedicine

The idea of receiving precision health care from the comfort of one’s home has only grown since the inception of telemedicine. Though still not widely adopted by the general public, telehealth is making up ground in becoming a viable option for some patients and providers.

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It’s also becoming a more viable option in the workers’ compensation industry, despite regulatory obstacles.

And while telemedicine has become something of a ‘buzzword’ in workers’ comp, many industry professionals are seeing that this practice produces positive results.

Over 550 workers’ comp professionals were surveyed for a Mitchell International Inc. study on telemedicine perception. The results showed that 45 percent of respondents see promise in telemedicine when it comes to cutting costs and impacting the industry. In fact, the U.S. telemedicine market is slated to grow at an annual rate of six percent over the next few years, likely to reach nearly $7 billion in value by 2020.

So exactly how is telemedicine impacting your workers’ comp claims?

More Physicians Are Available

Fewer health care practices are accepting workers’ compensation cases due to the continuously changing health care insurance climates and the pressures a workers’ comp patient might impose. This impacts workers’ comp firsthand as employers attempt to find treating physicians who will work with their needs. Telemedicine acts as a solution.

“The beauty of telemedicine is if a clinician is licensed in the state — they can practice in that whole state and provide care where there may not be any center even open at that time,” said Ann Schnure, vice president of telemed operations, Concentra Telemedicine, and a speaker at the upcoming 2018 National Workers’ Compensation and Disability Conference held Dec. 4 through 7 at the Mandalay Bay in Las Vegas.

While telemedicine has become something of a ‘buzzword’ in workers’ comp, many industry professionals are seeing that this practice holds positive results.

This technology has made it possible for injured workers to be assessed almost immediately after injury. Of course, catastrophic cases and other serious injuries need to be treated hands-on, but minor injuries can easily be diagnosed via video chat and conferencing with a certified physician.

This is a great tool to have in rural areas where the nearest health care facility is miles away. It’s also effective in places where the available physicians specialize in areas outside of the injuries suffered (an example: a burn victim in need of a burns specialist three towns over). Telemedicine taps into the physician network, allowing access to broader health care options.

Removing Transportation Struggles

Transportation is a multi-layer problem, said Schnure.

“It’s not just the cost of transportation but the costs of management around that transportation.”

Some workers might not have any means of transport for starters. Others may take taxis and have the receipts reimbursed. Some carriers and care managers have teamed up with ride-share

Ann Schnure, vice president, Concentra Telemedicine

companies like Lyft to get workers to their appointments, while others have nurse case managers coordinate drivers for the injured workers. But all these transportation costs add up.

“If you have someone who needs transportation on every visit, and say it’s a 20-mile drive around 50 cents per mile — that’s only about $10. But times that by five for multiple appointments, you’re at $50. Now say you have a thousand cases like that; it starts to add up.”

Telemedicine, however, eliminates the need for transportation altogether and encourages injured workers to seek guidance from their providers without leaving home. Check-ups and consultations can happen within minutes using video chat and a telecommunication device, like a smartphone or tablet.

Fewer Missed Appointments

On the other hand, injured workers who can transport themselves to and from their physicians’ offices might find themselves facing time issues. Appointments at a traditional doctor’s office typically coincide with work hours, leaving an injured worker to take paid time off or schedule an appointment before or after work. Taking off work and battling city traffic is not an easy decision for some.

“It’s the number one reason why patients stop following up,” Schnure said. “When they start feeling better, they will skip appointments.”

And missed appointments lead to longer claims.

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“A missed appointment can leave a case open,” said Schnure. “An open case has an opportunity for a person to be in a gray area” if their work restrictions expire and they did not continue with their care. Because if this happens, she explained, it’s up to the employer to decide if the worker can return to their job. If it’s too early in the healing process, the worker might face reinjury and a lengthened claim.

With telemedicine, however, a worker can check in at any time.

“It’s what one of our clients coined as ‘stay-at-work-visits,’ ” added Schnure.

Telemedicine Cuts Overall Costs

Researchers at Community Health Center and the University of Connecticut Health Center found that a telemedicine consult platform specific to cardiology cases saved almost $500 per patient in Medicaid costs over in-person treatments. While this is specific to cardiology, it’s a good indicator that telemedicine is cutting costs across the board.

In workers’ compensation, telemedicine can eliminate the need for emergency room visits (and their expensive bills), cut down on transportation expenditure, provide crisis intervention due to on-the-spot care and more.

Christine Williams, managing director, Worker’s Compensation Center of Excellence, U.S. Casualty Practice, Marsh, wrote in an article that telemedicine “could be the difference between good and bad claims outcomes.”

Williams cited having that instant access to a nurse or doctor as a primary reason telemedicine works to cut costs and get injured workers what they need. This fast-paced, instant ability to connect with a medical professional enables the claim to start out right. Just as quickly as the injury occurs, the worker can be assessed and prescribed the proper care.

“[Telemedicine] is another tool in the workers’ comp toolbox,” said Schnure. “The right injury gets directed to the right level of care. It reduces case duration and engages the employee in their return to work.” &

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

High Net Worth

High Net Worth Clients Live in CAT Zones. Here’s What Their Resiliency Plan Should Include

Having a resiliency plan and practicing it can make all the difference in a disaster.
By: | September 14, 2018 • 7 min read

Packed with state-of-the-art electronics, priceless collections and high-end furnishings, and situated in scenic, often remote locations, the dwellings of high net worth individuals and families pose particular challenges when it comes to disaster resiliency. But help is on the way.

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Armed with loss data, innovative new programs, technological advances, and a growing army of niche service-providers aimed at addressing an astonishingly diverse set of risks, insurers are increasingly determined to not just insure against their high net worth clients’ losses, but to prevent them.

Insurers have long been proactive in risk mitigation, but increasingly, after the recent surge in wildfire and storm losses, insureds are now, too.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy,” said Laura Sherman, founding partner at Baldwin Krystyn Sherman Partners.

And especially in the high net worth space, preventing that loss is vastly preferable to a payout, for insurers and insureds alike.

“If insurers can preserve even one house that’s 10 or 20 or 40 million dollars … whatever they have spent in a year is money well spent. Plus they’ve saved this important asset for the client,” said Bruce Gendelman, chairman and founder Bruce Gendelman Insurance Services.

High Net Worth Vulnerabilities

Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

As the number and size of luxury homes built in vulnerable areas has increased, so has the frequency and magnitude of extreme weather events, including hurricanes, harsh cold and winter storms, and wildfires.

“There is a growing desire to inhabit this riskier terrain,” said Jason Metzger, SVP Risk Management, PURE group of insurance companies. “In the western states alone, a little over a million homes are highly vulnerable to wildfires because of their proximity to forests that are fuller of fuel than they have been in years past.”

Such homes are often filled with expensive artwork and collections, from fine wine to rare books to couture to automobiles, each presenting unique challenges. The homes themselves present other vulnerabilities.

“Larger, more sophisticated homes are bristling with more technology than ever,” said Stephen Poux, SVP and head of Risk Management Services and Loss Prevention for AIG’s Private Client Group.

“A lightning strike can trash every electronic in the home.”

Niche Service Providers

A variety of niche service providers are stepping forward to help.

Secure facilities provide hurricane-proof, wildfire-proof off-site storage for artwork, antiques, and all manner of collectibles for seasonal or rotating storage, as well as ahead of impending disasters.

Other companies help manage such collections — a substantial challenge anytime, but especially during a crisis.

“Knowing where it is, is a huge part of mitigating the risk,” said Eric Kahan, founder of Collector Systems, a cloud-based collection management company that allows collectors to monitor their collections during loans to museums, transit between homes, or evacuation to secure storage.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy.” — Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

Insurers also employ specialists in-house. AIG employs four art curators who advise clients on how to protect and preserve their art collections.

Perhaps the best known and most striking example of this kind of direct insurer involvement are the fire teams insurers retain or employ to monitor fires and even spray retardant or water on threatened properties.

High-Level Service for High Net Worth

All high net worth carriers have programs that leverage expertise, loss data, and relationships with vendors to help clients avoid and recover from losses, employing the highest levels of customer service to accomplish this as unobtrusively as possible.

“What allows you to do your job best is when you develop that relationship with a client, where it’s the same people that are interacting with them on every front for their risk management,” said Steve Bitterman, chief risk services officer for Vault Insurance.

Site visits are an essential first step, allowing insurers to assess risks, make recommendations to reduce them, and establish plans in the event of a disaster.

“When you’re in a catastrophic situation, it’s high stress, time is of the essence, and people forget things,” said Sherman. “Having a written plan in place is paramount to success.”

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Another important component is knowing who will execute that plan in homes that are often unoccupied.

Domestic staff may lack the knowledge or authority to protect the homeowner’s assets, and during a disaster may be distracted dealing with threats to their own homes and families. Adequate planning includes ensuring that whoever is responsible has the training and authority to execute the plan.

Evaluating New Technology

Insurers use technologies like GPS and satellite imagery to determine which homes are directly threatened by storms or wildfires. They also assess and vet technologies that can be implemented by homeowners, from impact glass to alarm and monitoring systems, to more obscure but potentially more important options.

AIG’s Poux recommends two types of vents that mitigate important, and unexpected risks.

“There’s a fantastic technology called Smart Vent, which allows water to flow in and out of the foundation,” Poux said. “… The weight of water outside a foundation can push a foundation wall in. If you equalize that water inside and out at the same level, you negate that.”

Another wildfire risk — embers getting sucked into the attic — is, according to Poux, “typically the greatest cause of the destruction of homes.” But, he said, “Special ember-resisting venting, like Brandguard Vents, can remove that exposure altogether.”

Building Smart

Many disaster resiliency technologies can be applied at any time, but often the cost is fractional if implemented during initial construction. AIG’s Smart Build is a free program for new or remodeled homes that evolved out of AIG’s construction insurance programs.

Previously available only to homes valued at $5 million and up, Smart Build recently expanded to include homes of $1 million and up. Roughly 100 homes are enrolled, with an average value of $13 million.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work.” — Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“We know what goes wrong in high net worth homes,” said Poux, citing AIG’s decades of loss data.

“We’re incenting our client and by proxy their builder, their architects and their broker, to give us a seat at the design table. … That enables us to help tweak the architectural plans in ways that are very easy to do with a pencil, as opposed to after a home is built.”

Poux cites a remote ranch property in Texas.

Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“The client was rebuilding a home but also installing new roads and grading and driveways. … The property was very far from the fire department and there wasn’t any available water on the property.”

Poux’s team was able to recommend underground water storage tanks, something that would have been prohibitively expensive after construction.

“But if the ground is open and you’ve got heavy equipment, it’s a relatively minor additional expense.”

Homes that graduate from the Smart Build program may be eligible for preferred pricing due to their added resilience, Poux said.

Recovery from Loss

A major component of disaster resiliency is still recovery from loss, and preparation is key to the prompt service expected by homeowners paying six- or seven-figure premiums.

Before Irma, PURE sent contact information for pre-assigned claim adjusters to insureds in the storm’s direct path.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work,” said Curt Goetsch, head of underwriting for Ironshore’s Private Client Group.

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“If you’ve got custom construction or imported materials in your house, you’re not going to go down the street and just find somebody that can do that kind of work, or has those materials in stock.”

In the wake of disaster, even basic services can be scarce.

“Our claims and risk management departments have to work together in advance of the storm,” said Bitterman, “to have contractors and restoration companies and tarp and board services that are going to respond to our company’s clients, that will commit resources to us.”

And while local agents’ connections can be invaluable, Goetsch sees insurers taking more of that responsibility from the agent, to at least get the claim started.

“When there is a disaster, the agency’s staff may have to deal with personal losses,” Goetsch said. &

Jon McGoran is a novelist and magazine editor based outside of Philadelphia. He can be reached at [email protected]