Another health insurer is investing in a digital differentiator, offering members access to telehealth and choices in using it.
Premera Blue Cross, a nonprofit insurer for 1.9 million residents of Washington State and Alaska, is going to start offering virtual healthcare visits as a covered benefit starting in January 2015.
The Mountlake Terrace, Washington-based company is incorporating virtual care as a component of its delivery system coverage, "for diagnosis, prevention, health advice, disease management and treatment."
Members will have access to virtual clinical visits via two channels, through arrangements with their local providers or, for people who want 24/7 access to digital consults, through Teladoc, the largest telehealth medical consultation provider in the U.S.
Premera members who use Teladoc will be able to receive diagnosis and "select treatment services," Premera said, noting that "Teladoc is not intended to replace a member's primary care physician, but instead is designed as a convenient alternative" to urgent care and nonemergent visits to hospital emergency departments.
"The industry is moving toward offering people access to care at a place and time that is convenient to them," said Rich Maturi, Premera's senior vice president of healthcare delivery. "Our virtual care offering will allow us to meet our members where they are and also make it simple for them to get the care they need."
"By making telehealth services available, our members can have peace of mind that they will have access to virtual care any time of day," added Maturi, a former development VP at Cancer Treatment Centers of America. "This service provides a viable alternative when in-person care is a challenge due to geographic distance, limited access to transportation, and a need for care outside of regular doctor office hours." Telemedicine is increasingly in demand from consumers, and insurers have come around to covering it in many places, if not embracing it on an industry-wide basis.
Aetna has covered telemedicine in some markets for almost a decade. Cigna recently started offering telemedicine to self-insured clients through a partnership with MDLive, and Anthem Blue Cross this year expanded telemedicine benefits to 10 of its 14 states via its own subsidiary, LiveHealth Online. Arches Health Plan, a new cooperative insurer in Utah, is making telemedicine available to its network provider and then leaving it up to them to use it with members however they prefer.
Premera is combining two of the main models that have emerged, giving members the option to have digital consults their primary care physician or childrens' pediatrician, or with a doctor they've never met online -- a type of telemedicine that has been controversial among some medical associations who believe individuals should have established relationships with a doctor before getting a diagnosis or advice in a web chat.
Whatever the model, and despite lingering resistance from some medical groups, hospital associations and insurers, telemedicine is bound to become a common feature of the American health system.
Other Pacific Northwest insurers do cover telemedicine, though Premera appears to be the first with a comprehensive policy that includes a service like TeleDoc. Premera's for-profit affiliate subsidiary, Lifewise, is rolling out a similar two-pronged telehealth benefit in Oregon next year for its 52,000 members.
Twenty states require commercial insurers to reimburse providers for telehealth, while 43 Medicaid programs have some form of coverage of the digital consultation service.