5 Ways Telemedicine Can Cut Costs Without Cutting Corners in Workers’ Comp
The use of telemedicine is becoming more common than ever. A quick browse through a general care physician’s online portal shows options to text medical questions to a nurse, schedule a video appointment with a doctor and request a virtual exam.
Nationally, the use of telemedicine increased with an average annual compound growth rate of 261 percent between 2015 and 2017, according to the Washington Post.
While telemedicine is becoming increasingly common, workers’ compensation programs have been slower to adopt these new technologies.
Overall, workers’ compensation is seeing an increase in the area of telemedicine. In 2015, 56% of Kaiser Permenente’s interactions between physicians and members were virtual, according to NCCI data. A lack of guidance and differences in state regulations, however, can make telemedicine programs difficult to implement in workers’ compensation.
“I think telemedicine is a game changer,” Ann Schnure, vice president at Concentra Telemedicine, told Risk & Insurance®. “But you can’t [instantly] turn the switch on. You have to really think through what you are doing and what state you are in.”
“You are making a risk decision going forward in a state that says ‘we are going to make regulations, we just haven’t written them yet,’ she added.
Schnure will be speaking on telemedicine at the 2019 National Workers’ Compensation and Disability Conference® & Expo. Her session, “Leveraging Modern Telemedicine to Enhance Employer Workers’ Compensation Programs” will examine how telemedicine can streamline the workers’ compensation process, improve health outcomes and reduce costs.
Despite the regulatory obstacles that telemedicine may face, it’s a growing category of health care that can save time and money while still providing quality care for injured workers. Here are five ways telemedicine can enhance workers’ compensation care while helping to contain costs.
1) Injured Workers Don’t Have to Take Time Off Work to See a Doctor
For an injured worker facing a lost time claim, taking more time off after they’ve returned to work for additional medical appointments can be the last thing they want to do.
Since appointments often coincide with work hours, employees often start skipping their doctors appointments once they start feeling better to avoid taking time off work.
“It’s the number one reason why patients stop following up,” Schnure said. “When they start feeling better, they will skip appointments.”
When employees skip appointments, claims can run long past when the employee feels like they have healed.
If an employee’s work restrictions expire, for example, and they haven’t been cleared by a doctor, it’s up to employers to decide if they’re ready to return to work.
Employers aren’t doctors, however, and they may think that an employee who says that they feel better can come back full duty before the healing process is complete.
This is where telemedicine can step up by eliminating the need for injured workers who are on the up and up to continue physically attending their appointments. Instead, video calls can allow employees to check in with their doctors from the comfort of their homes or offices.
2) Getting Employees the Behavioral Health Care They Need
While the stigma associated with mental health conditions is decreasing, fear of being treated differently can still dissuade workers from seeking the behavioral health care they need.
Technology and telemedicine platforms can step in to help workers get the behavioral care they need. Patients may feel more comfortable texting a therapist or using coaching-centered text services to treat their behavioral health conditions.
Video calls can also help bring treatment to patients who have difficulty leaving their homes to due to severe depression or anxiety.
“The interesting reality on [televideo services] is that utilization remains woefully poor both on the medical side and on behavioral health,” said Dr. Alisa Trugerman, a principal at Mercer.
“Probably the place where we see the most change is often in the chat- and text-based approaches and they’re being used for both coaching and therapy.”
3) Virtual Doctors Help Combat the Physician Shortage
As we creep closer to 2025, the physician shortage will begin to feel like a very real concern.
The Association of American Medical Colleges reports that by 2032 the U.S. will face a shortage of nearly 122,000 physicians.
For workers’ compensation, the physician shortage could be particularly challenging as employers and insurers may have a difficult time keeping claims durations short if there are not enough doctors to see patients.
Telemedicine could ease the burden of some of the problems posed by the physician shortage by allowing doctors to see more patients in a shorter period of time. It can also allow injured workers to access high-level physicians and specialists who they may normally be unable to get an appointment with.
4) Claims and Medical Management is Just a Phone (or Video) Call Away
Telemedicine isn’t just a way to connect doctors with patients, however. It can also be used to connect injured workers with nurse case managers and other people who participate in the claims management process.
In a survey from 2017, 84% of respondents thought that telemedicine would improve automation and efficiency in claims and medical management.
“I think a whole bunch of the case management piece can be done telephonically. Certainly, it’s much less costly for the carriers, the TPAs, employers,” said Bonnie Dayhaw, vice president of clinical services at Ascential Care Partners.
Telephonic nurse case managers can also assist patients with typical or smaller injuries that wouldn’t necessarily require a case manager. And speaking with a case manager can help improve outcomes.
Starbucks, a 2018 Teddy Award winner, uses telephonic nurse case managers to help connect injured workers with care providers and answer questions about their injuries. Between 2015 and 2018, claims with nurse involvement went from 51 % release-to-work and deemed maximally medically improved (MMI) to 86 % release-to-work and deemed MMI.
5) Helping Rural and Elderly Workers Get into The Doctor’s Office
For some patients, travelling to see a doctor can be difficult if not almost impossible to achieve without incurring huge travel bills and for others travelling can put its own strain on their health.
Rural workers and elderly workers are two groups for whom travelling to see a doctor could pose financial or physical challenges. They stand to benefit from telemedicine services that make health care both cheaper and easier to attain for workers’ compensation payers.
“It’s not just the cost of transportation but the costs of management around that transportation,” Schnure said.
“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.”
Cost of care isn’t the only way telemedicine can benefit these groups, however. For rural patients, hospitals and specialized physicians may be several towns over, making care difficult to access. With telemedicine, these patients can speak to a doctor on the phone.
For older workers, a group that is becoming increasingly common in the workforce, travelling long distances for care can be physically taxing and could slow their recovery efforts.
The ability to video chat or call a doctor for some appointments could allow them to get the rest that is crucial for recovery. &