Growth in Telemedicine and E-Visitation May Reduce Health Care Costs, Premiums

Posted on Monday, April 01, 2019

The idea of e-visitation is to help reduce health care costs as well as overcrowding of hospitals and medical clinics. Patients go through an e-visit first for screening and basic recommendations. If an actual, in-person visit is warranted, the patient can then book an appointment to go to the doctor's office.

In many cases, though, the medical issue can be dealt with quickly and easily without necessitating an in-person visit. Examples include routine prescription renewals, prescriptions for minor pain issues, antibiotics for readily identified infections that can be remotely diagnosed, and doctor sick notes for routine minor ailments.

Limitations

The potential cost savings are significant - but they are not without tradeoffs. Some physicians' groups warn that trying to assess patients remotely increases the probability of a wrong diagnosis. For example, alert doctors can sometimes spot cases of childhood diabetes if a child's breath has a sweet, fruity smell. This occasionally happens even when a child is not being checked because of complaints of diabetes symptoms.

A doctor seeing a patient only via a camera cannot readily check vitals in person, or listen to patient's breathing, check manually for swollen lymph nodes or conduct a number of other routine checks that are a matter of course for in-person medical exams. In some cases, these missed diagnosis opportunities could be life-threatening.

On the other hand, wait times could be reduced and treatment improved at clinics and hospitals if non-emergency visits could be handled with simple e-visits.

Regardless, e-visitation is becoming more and more accepted, not only among medical professionals, but also among the general population. State licensing boards are beginning to adapt their standards and practices to the reality of telemedicine, and health insurance companies are integrating e-visits and telemedicine into their treatment approval protocols.

Increased Availability a Plus

One possible benefit is the improved availability of medical professionals on weekends and holidays. The new technology allows relatively few physicians to handle a lot of demand for routine visits.

The technology can also greatly benefit some elderly or chronically ill individuals who are shut-ins, or who are not easily transported to clinics or hospitals, whether because of their remote locations or their personal living conditions and available social supports.

Among the biggest potential winners, however, are those who have relatively high deductibles. The lower costs associated with e-visitation make a consultation with a doctor much less expensive than an ER visit or even an office visit - generally reducing out-of-pocket costs for both the patient and the insurance company. The difference can be dramatic - an ER visit can cost over a thousand dollars, whereas an e-visit can be had with a doctor in his office, viewing the patient over a webcam, for about $50.

The marginally insured, such as fast food and retail employees, may also benefit, because they must frequently obtain a doctor's note simply to justify a work absence. But these doctor's notes can be prohibitively expensive for those earning just over minimum wage - which frequently leads to presenteeism as workers show up to work despite their reduced productivity due to illness and the potential for being contagious.

In theory, such cost reduction should reduce medical insurance premiums, all things being equal, though the sheer number of factors that feed into insurance premium pricing makes telemedicine's eventual contribution to reduced medical insurance premiums difficult to quantify. Employers should eventually benefit significantly, however, as savings from telemedicine wind through the system.

Going forward, most experts expect e-visitation to become more and more common and accepted among medical professionals and patients alike. Employers are likely to embrace the changes to realize cost reductions in medical premiums.

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