The sudden surge in telehealth utilization–as well as the policy exceptions issued by insurers and the CMS–have led to other complications and confusion on the part of consumers. (Photo: fizkes/Shutterstock.com)
Telehealth has seen a surge in usage over the past several months amid the pandemic's stay-at-home orders and other precautionary measures. Adding to its tailwinds was private insurers' move to fully cover the cost of telehealth visits for consumers.
Though there's no end in sight for the pandemic, there is for telehealth reimbursements: As reported by STAT, As of October 1, UnitedHealthcare and Anthem will both discontinue full coverage for telehealth visits. Instead, patients will be on the hook for copays and other fees for non-COVID-related appointments, depending on their insurance plan.
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Reactions to the decisions have been mixed, with some decrying the impact it will have on consumers as the pandemic wears on. Others, however, see it as an important step towards restoring balance to health care utilization.
"The very advantage of telehealth — the fact that it makes care more convenient — is also its Achilles' heel, in the sense that it can make care too convenient," Ateev Mehrotra, a hospitalist at Harvard Medical School, told STAT, going on to note that there's nothing to discourage patients from scheduling unnecessary appointments and taking time away from consumers who may have serious health problems to discuss with their doctor.
According to STAT, CVS Health and some BlueCross BlueShield associations have extended their telehealth cost-sharing coverage through the end of the year.
The sudden surge in telehealth utilization–as well as the policy exceptions issued by insurers and the Centers for Medicare and Medicaid Services–have led to other complications and confusion on the part of consumers. For one, consumers may not have any idea what the final bill will be, given the different approaches taken by insurers and providers to coding the appointments. This has sparked a push to require insurers to cover telehealth reimbursements at the same rate as in-person visits.
Then, too, is understanding how different situations will be covered. UnitedHealth will still cover the full cost of COVID-related telehealth appointments, for example. And Anthem will require patients to pay a fee for video visits, but not telephone appointments.
Not knowing how much the final bill and insurance reimbursement for a telehealth visit will be is not just an issue for the patient, but the providers, as well. "To have a provider feel financial pressure to offer less telehealth and bring more patients into the office — because they have to pay the bills and keep the lights on and keep their practice running — is a pressure providers shouldn't have to face," Adam Licurse, executive director of the virtual care department at Brigham and Women's Hospital and Faulkner Hospital in Boston, told STAT.
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Emily Payne
Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.
