WellPoint Inc. and HealthNow New York Inc. (d/b/a BlueCross BlueShield of Western New York and BlueShield of Northeastern New York) have separately joined the ranks of health insurers offering some type of online capability to their plan members. WellPoint and HealthNow each have signed on to obtain Online Care services from American Well, following in the footsteps of Blue Cross Blue Shield of Hawaii, Blue Cross Blue Shield of Minnesota, OptumHealth and TriWest Healthcare Alliance (who all previously purchased the technology). "Additionally, the health system Ascension Health and retail pharmacy chain Rite Aid are rolling out Online Care services to their patients," says spokeswoman Lisa Gyllstrom. "After the passing of health reform, much of the uncertainty was eliminated and interest picked up right away," she notes.
Health plans are attracted by the savings possibilities, says Gyllstrom. "There is a significant cost savings potential for the healthcare system as a result of Online Care shifting appropriate medical visits to the home setting. Milliman Inc., a widely respected actuarial firm in the healthcare market, recently examined the financial impact of replacing in-person care for specific conditions deemed appropriate to treat with Online Care interactions in its Online Care Economic Studies Objective. The majority of savings estimated in the analysis came from the potential for substitution of non-emergent ER visits and in-person visits, such as: replacing non-emergent ER visits with Online Care visits; replacing in-person office visits for emerging conditions (e.g. a complaint on a headache, back pain or allergies) with an Online Care visit; and replacing applicable office visits for follow-up care (e.g. for Diabetes or Congestive Heart failure) with an Online Care visit."
The Milliman analysis "demonstrated potential medical savings of $3.36 and $6.95 per-member-per-month for commercial and Medicare plans, respectively," she adds.
The two HealthNow plans regard Online Care "as an innovative way for providers to interact with local patients who need care," says HealthNow spokeswoman Karen Merkel-Liberatore. The system will be particularly useful providing improved access to care for patients in underserved areas, she adds.
"We anticipate that Online Care will be a satisfier for both consumers and physicians and will help to minimize unnecessary trips to the ER and will support the needs of those living with chronic diseases," says Merkel-Liberatore. "Providers who are already using the system have found it very easy to use, and like the flexibility it offers. Also, Online Care is very attractive to consumers for many reasons. There is no calling to schedule an appointment, time away from work and home and waiting to be seen. Online sessions are done right from the consumer's home or office, and no appointment is required."
Online care is being offered in the Buffalo area as a service, rather than an insured benefit, and physicians are paid by the patient for the clinical consultation, notes Merkel-Liberatore. "Patients purchase a 10 minute block of time with the physician and pay using a credit or debit card. During the initial introduction of the program, primary care physicians will be paid $25 for each 10 minute, on-line consultation. The 10 minute conversation has been proven to be sufficient for both provider and patient in the vast majority of cases. If the provider believes more time is needed, he or she has the option to extend the conversation for an additional 3-5 minutes, subject to an additional fee."
Patients will have immediate access to doctors "through a system that pools together available providers by specialty, so the patient has his or her choice of an appropriate physician (including the primary care physician if available) in real-time, with no wait," she explains. "Patients also have the ability to make a future appointment for an online consultation, or wait online for the doctor of their choice. If a provider is not immediately available, but online with another patient, the physician is notified that patients are waiting in their 'virtual waiting rooms,' and the provider is able to review the patient's health summary in order to understand the health issue and determine if they are comfortable accepting the encounter. Physicians can make themselves available anytime, for as long as they choose."