More on Reimbursement

More insurers see case for telemedicine

Pretty soon, 24/7 digital access to a physician or nurse practitioner could be a standard health plan benefit.

WellPoint's Anthem Blue Cross plans are rolling out telemedicine services across their markets, most recently in Kentucky and Maine, as part of a strategy to increase value propositions to existing and potential members -- and also in part defending its territory.

Before the Affordable Care Act, Anthem Blue Cross and Blue Shield of Maine claimed more than half of the employer-sponsored and individual insurance markets. It's not clear where that stands now, exactly, but a new competitor, Maine Community Health Options, has boasted of garnering 80 percent of the membership from ACA marketplace.

With that slow start in the new individual market as a backdrop, Anthem is bringing a new telemedicine service to most of its Maine plans, including some exchange plans. Anthem Blue Cross and Blue Shield of Kentucky is doing likewise. 

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It's a part of WellPoint's national program for Anthem plans to offer digital consults through its own telemedicine business unit, LiveHealth Online, which was first deployed in California and Ohio early last year and is now expanding nationwide.

In Maine, a majority of Anthem plan members will have access to an online video consult with board-certified doctors 24 hours a day, 365 days year, via any internet-connected device with a webcam, at cost that's "the same or less than a primary care office visit."

"LiveHealth Online is part of a shift in healthcare delivery that is driven by technology and ultimately makes access to healthcare easier," said Dan Corcoran, president and general manager of Anthem Blue Cross and Blue Shield in Maine, in a media release. "While it's not intended to take the place of your primary care physician, we are pleased to offer our members another way to reach board-certified, U.S.-based doctors anytime they need with their smart phone, tablet or computer."

LiveHealth Online, a part of WellPoint's Health Management Corp. subsidiary, is open to anyone, charging $49 per consult. Anthem members will pay their typical primary care co-pay, which for many is around $20.

While anytime telemedicine services like LiveHealth are, of course, not a replacement for emergency are and have their critics, the digital consult is a fast-growing service that supports hope can optimize the convenience factor more and more Americans are seeking in healthcare.

As LiveHealth put its, online consults are well suited for at least a small chunk of concerns and ailments that bring members, especially parents with young children, to the primary care office -- colds, flus, allergies, sinus infections, bronchitis, rashes and diarrhea

"We view Live Health Online as a valuable resource for our primary care physicians to offer to help them meet the needs of enhanced access for their patients," said Jeffrey Holmstrom, DO, medical director for Anthem Blue Cross and Blue Shield in Maine.

Doctors with LiveHealth can write prescriptions for a range of medications -- though not for controlled substances or "lifestyle drugs," Anthem said -- and help the individuals decide if they need to see other providers. They'll also create a visit summary that can be forwarded onto primary care providers.

Whether or not telemedicine produces large-scale benefits and replaces a significant amount of what established primary care practices do, consumer demand for the services is continuing and that's compelling more and more insurers to offer some reimbursement for it.

Anthem's new competitor, Maine Community Health Options, also offers reimbursement for telemedicine services, and elsewhere insurers large and small are embracing services like LiveHealth or facilitating digital consults among network providers.

UnitedHealthcare is piloting the telemedicine in certain areas, Oscar Health, a New York City-area startup plan, offers telemedicine and free, unlimited phone calls with docs, and the Utah cooperative insurer Arches Health Plan has set up a telemedicine service with providers in its own network.