Utah's start-up health plan is offering a new service that could prove attractive to employers and individuals in a state with a growing tech hub, while also putting pressure on established players.
Arches Health Plan, a consumer-oriented and operated insurer created with federal loans, is now reimbursing providers in its network for telemedicine visits, clinician consultation with members via Internet video.
Salt Lake City-based Arches Health Plan is contracting with the company TruClinic as the telemedicine solution for its provider network, first for 1,000 providers and eventually to the entire network of 4,500-plus physicians. Through September, Arches is also making the telemedicine service available for providers to use with all their patients, not just its members.
The most notable component of the program, the insurer's leaders say, is that it will give providers a large financial incentive to use telemedicine -- something they haven't always had -- with 30 newly activated CPT codes for reimbursement of digital consults, including sessions conducted by physicians and non-physicians for primary and primary speciality care.
"The reimbursement codes are aimed at paying doctors to provide high quality care without the handcuffs of our archaic system," said Arches chief medical officer Douglas Roland Smith, MD, in a media release. "By embracing new ways of engaging our patients we finally make it about their needs and not just our needs."
Arches has already invested in using the medical home model in its health plans and TruClinic, which is also based in Salt Lake City, already works with a number of major providers in Utah, including the University of Utah Health Care.
The deal makes Arches the first co-op health plan and one of the first non-affiliated insurance companies to cover reimbursement for telemedicine. It gives the insurer a new way to differentiate itself from established players, especially in its marketing to younger consumer segments, such companies and workers in the small tech hub of greater Provo-Orem.
Arches now has 22,000 members across individual, small and large group segments, and also has another pitch to attract younger demographics: a "waiver of deductible for accidents" on all of its off-exchange plans, the message being: Go ahead, go mountain biking, rock climbing and skiing. We've got your back.
More insurers large and small are starting to pay for telemedicine in at least some of their plans, including UnitedHealthcare, which is piloting the service in certain areas, WellPoint, which is in the midst of expansion across markets, and Oscar Health, a New York City-area plan that offers telemedicine and free, unlimited phone calls with docs.