Despite a drop from this peak, telemedicine is here to stay. Of course, in-person visits continue to be necessary for patients who require physical exams and in-person procedures, but in the long-term, telemedicine can expand access to care. It offers a wider spectrum of provider interactions to patients living with a disability or seniors who lack transportation. Telemedicine also helps address the physician shortage. In some regions, the wait time to see primary care physicians (PCPs) can be weeks, and for specialists, it can be even longer. Many telemedicine vendors have developed a virtual primary care product that allows telemedicine to be a substitute for more than just urgent care visits.

Brokers and benefit advisors should ensure that employers are partnering with telemedicine providers so that employees have the option of virtual visits, if that's what they prefer.

Mental health 

The pandemic has taken a significant toll on people's emotional well-being and resulted in increased mental health issues. Many people experienced a loss of income, increased isolation, and in some cases, sickness and death. At the same time, social support has eroded, as people haven't been able to get together with friends and family. According to the CDC, the rates of depression and anxiety in June 2020 were three to four times higher than the rate for the corresponding time in 2019.

Due to these issues, there's been enormous demand for virtual mental health services. Prior to the pandemic, mental health services delivered by telemedicine was rare—used in fewer than 1% of visits. By contrast, in early October 2020, 41% of mental health visits were conducted via telemedicine. Going forward, employers will want to consider coverage for digital mental health solutions and ensure networks have providers who can offer teletherapy.

Digital diabetes management

COVID-19 was particularly concerning for people with pre-existing conditions such as diabetes.

In general, diabetes is manageable with proper nutrition and treatment; however, the pandemic has wreaked havoc on people's ability to manage this condition. Many resorted to comfort food or stopped exercising as a way to cope with isolation and financial hardships.

For employers, diabetes continues to be a top concern, as it affects many people and results in significant costs. According to the CDC, 34.2 million people of all ages had diabetes as of 2018, and direct costs of diabetes skyrocketed to $237 billion that same year.

Related: Digitalizing benefits packages creates a world of opportunity

For those living with diabetes, digital management offers significant help. Blood sugar levels can be monitored via mobile devices. Through a digital program with access to a virtual health coach, patients have the tools and support to build healthy lifestyle habits and make wise choices about food and exercise. These programs have produced clinically significant improvements in diabetes management.

More employers are interested in digital solutions for diabetes management, and brokers should be aware of the different programs available in the marketplace and what makes some more effective than others.

Digital musculoskeletal programs

Musculoskeletal (MSK) conditions affect bones, joints, and muscles. Common MSK conditions include strains and sprains; back, hip, and neck pain; carpal tunnel syndrome, and tendonitis. If left unmanaged, MSK conditions can result in chronic pain, costly surgery, disability, and opioid addiction.

An estimated 126.6 million Americans (1 in 2 adults) are affected by at least one MSK condition. These issues cost an estimated $213 billion in annual treatment, care and lost wages, according to a report issued by the United States Bone and Joint Initiative (USBJI).

The pandemic has played a role in increasing MSK issues. Injuries reemerged as people had less time to take care of themselves. Kids were being schooled at home, and remote work has led to long hours often with non-ergonomic workstations. In these situations, self-care fell to the wayside, and people haven't been moving as much as they would in an office setting.

In studies, digital MSK programs, which include remote physical therapy (PT), have produced a 69% pain reduction in average participants. In some cases, digital programs can eliminate the need for surgery and reduce depression and anxiety that accompany such injuries. Overall, these programs aim to teach patients to self-manage, so the need for surgery, PT and other services are reduced.

Wellness programs

Even as the nation begins to return to normal, many employees will still work remotely. As such, employers have had to modify their wellness offering accordingly.

In the past, wellness programs offered reimbursement for gym memberships, health coaching and nutritional education. Now, these programs are being modified to include options for live-streaming fitness classes, app-based health coaching, and childcare for working parents. In the past, where employers might have used participation incentives like gift cards to restaurants and movie theaters, now incentives may encompass at-home meal services or streaming entertainment services.

Employee engagement has also had to evolve. Engagement was challenging before the pandemic, but now there's an added layer of complexity with remote employees. Instead of relying solely on flyers around the office to promote programs, employers are also leveraging technology, such as online member portals, email blasts and Slack channels to keep employees informed. They may also host virtual wellness fairs to roll out new programs. 

ER solutions

As the coronavirus spread in the spring of 2020, visits to emergency rooms decreased by 42% over four weeks in April, compared with the same period in 2019. This meant a sharp decrease in the number of people seeking emergency care for reasons other than COVID-19.

The CDC found that in the 10 weeks after COVID-19 was declared a national emergency, ER visits declined 23% for heart attack, 20% for stroke, and 10% for hyperglycemic crisis.

Employers should have ER solutions in place that follow CDC guidelines to ensure unnecessary ER visits are redirected to telemedicine or other health care providers, while those patients who truly have a medical emergency can be safely routed to an ER. When appropriate, use of ER alternatives translates into lower out-of-pocket expenses for members and savings for employers. In total, a mid-sized group might save hundreds of thousands of dollars, and a large group, millions.

Ongoing digital health evolution

COVID-19 has certainly pushed digital health forward. The predominantly in-person model has been reimagined to utilize virtual solutions, when appropriate. There's also an expansion of remote monitoring of patients with chronic conditions. Mobile devices help ensure their vital statistics stay within a healthy range.

Brokers should ensure that a benefits administrator can coordinate all of an employer's digital point solutions into one seamless offering. This administrator needs to provide plan members with access to customer service representatives who are trained in the employer's health plan and digital health options, so plan members can get questions answered quickly via phone or chat. In addition, a benefits administrator can provide data to assess the effectiveness of various digital health initiatives.

Digital programs do require some upfront investment of time and effort for set up and training. But once these programs are in place, employers reap significant rewards; chief among them is the ability to foster a happier, healthier, and more productive workforce.

Keri Dixon is the executive vice president of product and account management at HealthComp, where she works to create a seamless and radically simple health benefits experience for employers and employees. She regularly collaborates with brokers and benefit advisors to design innovative health benefits that meet the specific needs of employers and their member populations.