How Digital Health Platforms Affect Healthcare Costs

by Ree AI Health Tech Med Tech

As healthcare costs continue to go up, digital health platforms are emerging as powerful cost-cutting tools. The global digital health market size was estimated at $240.9 billion in 2023 and is projected to grow at a compound annual growth (CAGR) of 21.9% from 2024 to 2030. 

These platforms are not just fancy apps or websites. From telehealth to AI-powered diagnostics, digital health applications are changing healthcare for the better. 

How do these platforms trim the fat from our bloated healthcare system? Let’s explore the ways digital health can make healthcare more affordable for everyone.

Contents

Telemedicine: Healthcare at Your Fingertips

Telemedicine brings healthcare right to your home, office, or wherever you are. It’s like having a doctor in your pocket! But how does this convenience translate to cost savings?

Woman in green sweater talking to doctor on Zoom

Virtual doctor visits reduce travel and waiting room costs

A study published in the Journal of Medical Internet Research found that telehealth visits saved patients an average of 100 minutes of travel time and $50 in travel costs per visit (Snoswell et al., 2020).

Think about the last time you went to the doctor. How much time did you spend traveling and sitting in the waiting room? With telehealth, those time and money costs disappear. 

Fewer ER visits

How often have you wondered if that late-night stomach ache was worth a trip to the ER? Telehealth tools like AI chatbots can help you make that decision without leaving home. 

Cost savings for both patients and healthcare providers

It’s not just patients who save money. Healthcare providers benefit too. Telehealth services have been found to reduce healthcare costs for providers and patients. Even better, many insurers now have an allowance to cover the cost of certain telehealth visits.

Preventive Care: Stopping Problems Before They Start

Have you ever heard the saying “an ounce of prevention is worth a pound of cure”? Digital health platforms are making this old adage more relevant than ever.

How digital platforms promote healthy habits

Fitness app in the gym

From step counters to diet trackers, digital health apps are helping us stay healthier. But do they really make a difference? A study by Ernsting et al. (2017) found that users of health and fitness apps were 34% more likely to meet physical activity guidelines compared to non-users.

Wearable devices and their impact on early detection

glucose monitor on arm with phone app showing glucose level

Smartwatches surpass the practical use of telling time–they’re becoming powerful health monitors. For example, Apple Watch’s ECG feature can detect atrial fibrillation with 98% accuracy, potentially preventing strokes and saving lives (Perez et al., 2019).

How AI and big data can predict health risks and reduce costs

Big Data Analytics in healthcare uses AI, machine learning and deep learning tools to help doctors find the best treatments for each patient, which can reduce waste. This lets doctors predict health problems  and start treatments early, which can save lives. This could change how common certain diseases are and save money on healthcare (Batko & Ślęzak, 202​​2).

Cost savings through prevention vs. treatment

Prevention isn’t just better for our health—it’s better for our wallets too. The Centers for Disease Control and Prevention estimates that chronic diseases that are avoidable through preventive care account for 75% of the nation’s healthcare spending.

Streamlined Administrative Processes

Paperwork is no one’s favorite part of healthcare. Digital platforms are making administrative tasks faster, easier, and more cost-effective.

Automated appointment scheduling and reminders

Have you ever forgotten a doctor’s appointment? Digital reminders can help. 

Smartwatch with phone and dumbbells

Ulloa-Pérez et al. (2022) found that sending an extra text reminder for high-risk appointments reduced no-shows in primary care and mental health offices, and same-day cancellations in primary care offices. 

Targeting reminders using risk prediction models (predictive analytics) can efficiently use healthcare resources, potentially preventing hundreds of missed visits monthly. This approach saves costs compared to messaging all patients, though implementing the risk model has some costs.

Digital health records reduce paperwork and administrative errors 

Nurse charting

Remember when doctors used to write prescriptions by hand? Digital health records make all kinds of admin work more efficient. A study in the Journal of the American Medical Informatics Association found that electronic health records with AI can reduce medication and billing errors.

Cost savings through improved workflow and resource allocation

Efficient workflows mean better care at lower costs. A study in the Journal of Medical Internet Research found that digital health platforms improved hospital workflow efficiency by 25%, leading to annual cost savings of $1.2 million for a mid-sized hospital (Luo et al., 2019).

Person looking at white overlay

Data-Driven Insights for Better Decision Making

In the age of big data, information is power. Healthcare is no exception. With all this digital information, doctors can make smarter choices about your health. 

How big data analytics improve treatment plans

A study in the Journal of Big Data found that big data analytics improved treatment efficacy by 30% and reduced treatment costs by 20% (Dash et al., 2019).

Cost savings from shorter and fewer hospital stays

Nurse standing in a recovery room

Have you ever wondered how hospitals decide how many beds they need? Predictive analytics is the answer. It can reduce hospital bed shortages and decrease operational costs.

Hospital stays are expensive, but RPM can help shorten them. RPM allows patients to be discharged an average of 2 days earlier, resulting in cost savings of $7,000 per patient.

Personalized medicine and its impact on cost reduction

One size doesn’t fit all in healthcare. Targeted treatments are more effective and cost-effective. 

  • Personalized treatment plans based on genetic data improve treatment efficacy and reduce adverse drug reactions (ADRs).
ECG monitor closeup on stomach

Remote Patient Monitoring: Reducing Hospital Stays

Sometimes, the best hospital care happens outside the hospital. 

Remote patient monitoring (RPM) allows health providers to keep an eye on patients without keeping them in the hospital. From smart pills to wearable sensors, remote monitoring technologies are diverse and growing. 

Impact on reducing hospital readmissions

Nobody likes going back to the hospital. Remote monitoring can help prevent that. A study in the New England Journal of Medicine found that remote monitoring reduced hospital readmissions for heart failure patients by 50% (Perez et al., 2019).

Management of chronic conditions from home

Gentleman taking his blood pressure in tan shirt

Chronic conditions are a major driver of healthcare costs. Remote monitoring can help manage these conditions more effectively. 

A 2024 study showed that telehealth reduces healthcare costs by cutting down on hospital visits, travel time, and missed work, especially for managing chronic conditions. This benefits both patients and healthcare systems financially (Prasad Vudathaneni et al., 2024).

Increasing Access to Specialized Care

Specialized care can be hard to access, especially in rural areas. Digital health isn’t just about general care – it’s also bringing expert help to more people.

Telehealth solutions for rural and underserved areas

Rural healthcare access is a major challenge. Telehealth can help bridge that gap. A study in Health Affairs found that telehealth increased access to specialty care in rural areas by 54%.

Telehealth also faces challenges like high setup costs and outdated payment models, especially in rural areas. Its success depends on cost distribution, clinical outcomes, and indirect savings. Hospitals need funding and strategies to reach underserved groups and ensure fair access to telehealth (Anawade et al., 2024).

Virtual second opinions and their impact on treatment decisions

Getting a second opinion can be life-changing. Virtual platforms make it easier than ever. Virtual second opinions can change the diagnosis or treatment plan in over one-third of cases, potentially avoiding unnecessary procedures and costs.

Conclusion

Digital health platforms are powerful allies to counteract rising healthcare costs. By leveraging technology for prevention, efficiency, and data-driven insights, these platforms are making healthcare more accessible and affordable. From applications like telehealth reducing unnecessary ER visits to catching illnesses early with AI-powered diagnostics, the potential for cost savings is huge. 

As patients, we can embrace these digital tools to take control of our health and potentially lower our healthcare expenses. For healthcare providers, adopting these platforms could lead to more efficient operations and better patient outcomes. 

What do you think about these digital health innovations? Have you used any of these technologies in your own healthcare journey? 

References

Anawade, P. A., Sharma, D., & Gahane, S. (2024). A Comprehensive Review on Exploring the Impact of Telemedicine on Healthcare Accessibility. Cureus, 16(3). doi.org/10.7759/cureus.55996

Batko, K., & Ślęzak, A. (2022). The use of Big Data Analytics in healthcare. Journal of Big Data, 9(1). doi.org/10.1186/s40537-021-00553-4

Centers for Disease Control and Prevention. (2021). Chronic diseases in America. Retrieved from https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm

Dash, S., Shakyawar, S. K., Sharma, M., & Kaushik, S. (2019). Big data in healthcare: Management, analysis and future prospects. Journal of Big Data, 6(1), 1-25. doi.org/10.1186/s40537-019-0217-0

Ernsting, C., Dombrowski, S. U., Oedekoven, M., & Kanzler, M. (2017). Using smartphones and health apps to change and manage health behaviors: A population-based survey. Journal of Medical Internet Research, 19(4), e101.

Grand View Research. (2024). Digital Health Market Size, Share & Trends Analysis Report By Technology (Healthcare Analytics, mHealth), By Component (Hardware, Software, Services), By Application, By End-use, By Region, And Segment Forecasts, 2024 – 2030. Retrieved from https://www.grandviewresearch.com/industry-analysis/digital-health-market

Luo, L., Li, J., Liang, X., Zhang, J., & Guo, Y. (2019). A cost-effectiveness analysis of a mobile-based care model for community-dwelling elderly individuals. Journal of Medical Internet Research, 21(5), e13563.

Perez, M. V., Mahaffey, K. W., Hedlin, H., Rumsfeld, J. S., Garcia, A., Ferris, T., Balasubramanian, V., Russo, A. M., Rajmane, A., Cheung, L., Hung, G., Lee, J., Kowey, P., Talati, N., Nag, D., Gummidipundi, S. E., Beatty, A., Hills, M. T., Desai, S., … Turakhia, M. P. (2019). Large-scale assessment of a smartwatch to identify atrial fibrillation. New England Journal of Medicine, 381(20), 1909-1917.

Personalized Medicine Coalition. (2020). The personalized medicine report: Opportunity, challenges, and the future. Retrieved from http://www.personalizedmedicinecoalition.org/Userfiles/PMC-Corporate/file/The-Personalized-Medicine-Report1.pdf

Prasad Vudathaneni, V. K., Lanke, R. B., Mudaliyar, M. C., Movva, K. V., Kalluri, L. M., & Boyapati, R. (2024). The Impact of Telemedicine and Remote Patient Monitoring on Healthcare Delivery: A Comprehensive Evaluation. Cureus, 16(3). doi.org/10.7759/cureus.55534

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), e17298.

Ulloa-Pérez, E., Blasi, P. R., Westbrook, E. O., Lozano, P. , Coleman, K. F., & Coley, R. Y.  (2022). Pragmatic Randomized Study of Targeted Text Message reminders to Reduce Missed Clinic Visits. The Permanente Journal, 26(1), doi/10.7812/TPP/21.078

Winstead, E. (2023). Telehealth Can Save People with Cancer Time, Travel, and Money. National Cancer Institute. Retrieved from https://www.cancer.gov/news-events/cancer-currents-blog/2023/telehealth-cancer-care-saves-time-money

Telehealth Mental Health Therapy: A Comprehensive Guide

Telehealth Mental Health Therapy: A Comprehensive Guide

by Ree AI Health Tech Med Tech

Telehealth mental health therapy has become increasingly popular, offering a convenient and accessible way for people to receive mental health support. This article will explore the world of online therapy, its benefits, challenges, and best practices for both providers and patients.

Contents

What is Telehealth Mental Health Therapy?

Telehealth mental health therapy (also known as telemental health, teletherapy, telepsychiatry, or online therapy) is the delivery of mental health services through digital platforms. It allows patients to connect with licensed mental health professionals remotely using video conferencing, phone calls, or text-based communication.

Definition and key components of telehealth mental health therapy

Woman in green sweater talking to doctor on Zoom

Telehealth therapy encompasses a wide range of mental health services provided through technology. The key components include:

  • Video conferencing sessions

  • Phone therapy sessions

  • Text-based therapy

  • Online mental health assessments

  • Digital tools and resources for mental health management

Types of mental health services offered via telehealth

Telehealth platforms offer various mental health services, including:

  • Individual therapy

  • Couples counseling

  • Group therapy

  • Psychiatry and medication management

  • Crisis intervention

85% of mental health providers offered telehealth services during the COVID-19 pandemic, with many saying they’d continue offering them services in the future (Pierce et al., 2021).

In an AAP study, 85% of pediatricians said they use telehealth for mental health visits, and over 80% of them said telehealth was very or moderately effective for mental health visits.

Platforms and technologies used for online therapy sessions

Several platforms and technologies are used to facilitate online therapy sessions:

  • HIPAA-compliant video conferencing software (Zoom for Healthcare, Doxy.me)

  • Secure messaging platforms

  • Mobile apps for mental health support

  • Virtual reality (VR) platforms for exposure therapy

For examples of how some organizations have successfully used telehealth in treatment programs for people experiencing homelessness, substance abuse disorders and mental disorders, review Chapter 4, “Examples of Telehealth Implementation in Treatment Programs from the Substance Abuse and Mental Health Services Administration (SAMHSA). 

Benefits of Online Mental Health Support

Telehealth mental health therapy offers numerous advantages over traditional in-person therapy.

Improved accessibility for rural and underserved populations

Telehealth therapy greatly improves access to mental health care for people in remote or underserved areas.

A 2024 study noted that many health providers had reduced no-show rates for behavioral health, and increased patient adherence to recommended behavioral health visits. One reason why is the potential for telehealth to mitigate anxieties that can surround in-person visits (Azar et al., 2024).

Lin et al (2018) found that health centers located in rural areas were more likely to use telehealth for mental health care, compared to those in urban areas.

A 2019 study found that telehealth significantly improved access to mental health care for rural populations, with a 45% increase in utilization of mental health services (Barnett et al., 2019).

Flexibility in scheduling and location

Online therapy allows for greater flexibility in scheduling appointments and choosing a comfortable location for sessions, which is beneficial for:

  • People with busy work schedules

  • Parents with childcare responsibilities

  • Individuals with mobility issues or disabilities

Less stigma 

Telehealth therapy can help reduce the stigma associated with seeking mental health support. Allowing patients to receive care from the privacy of their own homes removes the potential embarrassment of being seen entering a therapist’s office.

Cost-effectiveness compared to traditional therapy

Online therapy can be more cost-effective than traditional in-person therapy. A 2020 study found that telehealth mental health services were about 53% less expensive than in-person services (Lattie et al., 2020).

Challenges and Limitations of Telehealth Therapy

While telehealth therapy offers many benefits, it also comes with its own set of challenges and limitations.

Software and internet connectivity issues

One of the most common challenges in telehealth therapy is technical difficulties. These can include:

  • Poor internet connection

  • Audio or video quality issues

  • Software glitches

Younger generations tend to find virtual doctor visits easier than older generations. In any case, minimize these issues with a backup plan, like switching to a phone call if video conferencing fails.

Privacy and confidentiality concerns

Ensuring privacy and confidentiality in online therapy sessions is crucial. Therapists must use HIPAA-compliant platforms and take steps to protect patient information. patients should also be aware of their surroundings and ensure they have a private space for sessions.

Difficulty reading non-verbal cues

In video therapy sessions, it can be challenging for therapists to pick up on subtle non-verbal cues that might be more apparent in person. 68% of therapists reported difficulty in observing non-verbal communication during online sessions (Stoll et al., 2018).

Limitations for certain types of therapy or severe mental health conditions

While telehealth therapy is effective for many mental health conditions, it may not be suitable for all situations. Some limitations include:

  • Severe mental health conditions requiring in-person monitoring

  • Certain types of group therapy

  • Some forms of play therapy for children

How to Choose a Telehealth Mental Health Provider

If you’re considering telehealth therapy, here’s what to look for when selecting a provider for the best therapy experience.

Licenses and credentials

When choosing a telehealth therapist:

  • Verify the therapist’s license and credentials

  • Check if they are licensed to practice in your state

  • Look for specialized training in telehealth therapy

Platforms and security measures

Ensure that the therapist uses a secure, HIPAA-compliant platform for sessions. Ask about their privacy policies and data protection measures.

Insurance coverage and payment options

Check if your insurance covers telehealth therapy services. Many insurance providers have expanded their coverage for online mental health support in recent years. The Kaiser Family Foundation’s 2023 Employer Health Benefits Survey found that 91% of large employers included telehealth coverage in their health plans.

Assessing the fit between therapist and patient in a virtual setting

Finding the right therapist is crucial for successful therapy. Consider:

  • The therapist’s areas of expertise

  • Their approach to therapy

  • Your comfort level during initial consultations

Many telehealth platforms offer free initial consultations to help you find the right fit.

Best Practices for Effective Telehealth Therapy Sessions

To get the most out of telehealth therapy, therapists and patients should follow certain best practices.

Older woman using tablet

Set SOPs

Before starting telehealth services, the American Psychiatric Association recommends that providers assess their needs for training, space, and types of services. Organizations offering online mental health care should create standard procedures (SOPs), including quality improvement plans and ways to document provider credentials. 

Create a suitable environment for online sessions

Set up a quiet, private space for therapy sessions. This might include:

  • Using headphones for better audio quality and privacy

  • Ensuring good lighting for video sessions

  • Minimizing potential distractions

Prepare your tech and make backup plans

Before each session:

  • Test your internet connection

  • Ensure your device is fully charged

  • Have a backup plan (e.g., phone number) in case of technical issues

Establish rapport and trust

The American Psychological Association recommends developing a standard method for identifying both patients and providers at the start of each session. This could involve the provider stating their name and credentials, and asking the patient to provide their name and location. These guidelines help ensure professional and effective telehealth mental health services (Palmer et al., 2022).

Building a strong therapeutic relationship is just as important in online therapy as it is in person. Therapists should:

  • Use active listening techniques

  • Maintain eye contact by looking at the camera

  • Encourage open communication about the online therapy experience

Do therapy exercises and homework remotely

Woman touching cell phone with pink fingernails

Many therapeutic techniques can be adapted for online sessions. This might include:

  • Screen sharing for worksheets or educational materials

  • Using online tools for mood tracking or journaling

  • Assigning and reviewing homework through secure messaging platforms

A 2020 study found that 89% of patients were satisfied with their online therapy experience when therapists effectively adapted their techniques for the virtual setting (Wind et al., 2020).

Carry malpractice insurance

The American Telemedicine Association recommends telehealth providers to get malpractice insurance that covers online therapy (Palmer et al, 2022). 

When providing behavioral health care via telehealth, consult the American Psychological Association and American Psychiatric Association standards of care to ensure you’re providing ethical, quality care (Palmer et al., 2022).

The Future of Telehealth in Mental Health Care

The field of telehealth mental health therapy is rapidly evolving, with exciting developments on the horizon.

Some emerging trends in telehealth mental health care include:

  • AI-powered chatbots for initial assessments and support

  • VR therapy to treat phobias and post-traumatic stress disorder (PTSD)

  • Wearable devices for real-time mood and stress monitoring

Integration with traditional therapy models

Many mental health providers are adopting a hybrid model, combining in-person and online therapy sessions. This approach allows for greater flexibility and personalization of care.

Potential for AI and machine learning in mental health support

AI and machine learning can revolutionize mental health care by:

  • Analyzing patterns in speech and facial expressions to detect early signs of mental health issues

  • Providing personalized treatment recommendations based on large datasets

  • Offering 24/7 support through AI-powered chatbots

Ongoing research and development in the field

Researchers continue to study the effectiveness of telehealth therapy and develop new technologies to improve mental health care. A 2022 meta-analysis of 56 studies found that telehealth therapy was as effective as in-person therapy for treating a wide range of mental health conditions (Fernandez et al., 2022).

Conclusion 

Telehealth mental health therapy can be a convenient, effective, and accessible way to access mental health support, especially in rural and underserved areas.

Whether you’re considering online therapy, or just curious about its potential, the growth of telehealth mental health services marks an exciting development in the field of mental health care. Take the first step towards better mental health today by exploring the telehealth options available to you.

References

AAP Research. (2023). AAP study shows telehealth use common in pediatric care. American Academy of Pediatrics (AAP). Retrieved from https://publications.aap.org/aapnews/news/23772/AAP-study-shows-telehealth-use-common-in-pediatric

American Psychiatric Association. (2022). Best Practices in Synchronous Videoconferencing-Based Telemental Health. Retrieved from https://www.psychiatry.org/getattachment/b87211d5-81bb-4d4f-af73-9caa738c2a1c/Resource-Document-Telemental-Health-Best-Practices.pdf/

Azar, R., Chan, R., Sarkisian, M., Burns, R. D., Marcin, J. P. , Gotthardt, C. De Guzman, K. R., Rosenthal, J. L., & Haynes, S. C. (2024). Adapting telehealth to address health equity: Perspectives of primary care providers across the United States. Journal of Telemedicine and Telecare; 1-7. doi:10.1177/1357633X241238780

Barnett, M. L., Ray, K. N., Souza, J., & Mehrotra, A. (2019). Trends in Telemedicine Use in a Large Commercially Insured Population, 2005-2017. JAMA; 320(20), 2147-2149.

Berger, E. (2021). No-Cancel Culture: How Telehealth is Making it Easier to Keep That Therapy Session. Kaiser Family Foundation (KFF) Health News. Retrieved from https://kffhealthnews.org/news/article/no-cancel-culture-how-telehealth-is-making-it-easier-to-keep-that-therapy-session/

Dr. Josh. The Impact of Telemedicine on Mental Health. SmartClinix. Retrieved from https://smartclinix.net/the-impact-of-telemedicine-on-mental-health/

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2022). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy; 29(4), 1307-1321.

How do I use telehealth for behavioral health care? (n.d.). Health Resources & Services Administration (HRSA). Retrieved from  https://telehealth.hhs.gov/patients/additional-resources/telehealth-and-behavioral-health

Kaiser Family Foundation. (2023). 2023 Employer Health Benefits Survey. Retrieved from https://www.kff.org/report-section/ehbs-2023-summary-of-findings/

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2020). Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review. Journal of Medical Internet Research; 22(7), e15396.

Lin, C. C., Dievler, A. , Robbins, C., Sripipatana, A., Quinn, M. & Nair, S. (2018). Telehealth in Health Centers: Key Adoption Factors, Barriers, and Opportunities. Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05125

Macmillan, C. (2021). Why Telehealth for Mental Health Care is Working. Yale Medicine. Retrieved from https://www.yalemedicine.org/news/telehealth-for-mental-health/

Palmer, C. S., Brown Levey, S. M., Kostiuk, M., Zisner, A. R., Tolle, L. W., Richey, R. M., & Callan, S. (2022). Virtual Care for Behavioral Health Conditions. Primary Care; 49(4), 641-657. doi.org/10.1016/j.pop.2022.04.008

Pierce, B. S., Perrin, P. B., Tyler, C. M., McKee, G. B., & Watson, J. D. (2021). The COVID-19 telepsychology revolution: A national study of pandemic-based changes in U.S. mental health care delivery. American Psychologist; 76(1), 14–25.

Stoll, J., Müller, J. A., & Trachsel, M. (2018). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in Psychiatry, 9, 698.

Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders. (2021). Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from https://store.samhsa.gov/sites/default/files/pep21-06-02-001.pdf

Telehealth in Mental Health Counseling: Benefits and Barriers. (2023). Walsh University. Retrieved from https://online.walsh.edu/news/telehealth-mental-health-benefits-barriers/

What is Telemental Health? (n.d.). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/what-is-telemental-health

Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health. Internet Interventions; 20, 100317.

Understanding Your Telehealth Insurance Options

Understanding Your Telehealth Insurance Options

by Ree Health Tech

The convenience of healthcare access from your home makes telehealth more popular than ever. According to McKinsey, telehealth usage has stabilized at levels 38 times higher than before the pandemic. This surge in virtual care has prompted many insurance providers to expand their telehealth coverage, but you may not know how their telehealth insurance options work. 

Whether you’re looking for convenient access to medical professionals or seeking cost-effective healthcare solutions, you need to understand the telehealth insurance options available to you.

First, let’s explore what telehealth is and why coverage matters.

Contents

What is Telehealth and Why is Insurance Coverage Important?

Telehealth has become a buzzword in recent years, especially with the rise of digital health platforms and the COVID-19 pandemic. 

Telehealth, fairly synonymous with telemedicine, refers to the use of tech to provide healthcare services remotely. This can include video consultations, secure messaging, remote monitoring, texting, audio-only calls, and even virtual prescription refills. 

Benefits of telehealth services

In November 2021, 55% of respondents said they were more satisfied with telehealth or virtual care visits than with in-person appointments. 35% use other digital services, such as ordering prescriptions online and home delivery.

Telehealth benefits patients and healthcare providers in many ways (Hasselfeld, n.d.):

  • Convenience: Patients can consult with their healthcare providers from the comfort of their homes, which eliminates the need for travel and reduces wait times.

  • Access to Care: Telehealth is particularly beneficial for people in rural areas or those with mobility issues, providing access to specialists and primary care providers who may not be available in the local area.

  • Cost-Effective: By reducing the need for physical visits, telehealth can lower healthcare costs for both patients and providers.

  • Preventive Care: Regular virtual check-ups can help in the early detection and management of chronic conditions, improving overall health outcomes.

Importance of insurance coverage for telehealth

Insurance coverage for telehealth services is crucial for several reasons:

  • Reduced Out-of-Pocket Costs: Without insurance, telehealth costs can add up quickly. Insurance coverage helps mitigate these expenses.

  • Access to a Broader Network: Insurance plans often have agreements with a network of providers, making it easier for patients to find in-network telehealth services.

  • Comprehensive Care: Insurance can cover a wide range of telehealth services, from primary care to specialist consultations, ensuring that patients receive comprehensive care.

Now that we understand the basics of telehealth, let’s look at the different types of insurance plans that offer coverage for these services.

Types of Insurance Plans with Telehealth Coverage

When it comes to telehealth, not all insurance plans are created equal. 

One study found that insurers paid less for third-party telehealth visits than in-person care. Before COVID-19, only six U.S. states required equal payment for telehealth and in-person visits. By late 2021, more states adopted these laws, reducing potential cost savings for insurers as telehealth payments increased (Cuellar et al., 2022).

Here’s a breakdown of the different types of insurance plans that cover telehealth services.

Traditional health insurance 

Most traditional/private health insurance plans now include telehealth benefits. These plans cover a variety of services such as video consultations, e-prescriptions, and remote monitoring (HRSA, 2023).

Standalone telehealth insurance

Some companies offer standalone telehealth insurance plans. These are subscription-based services that provide unlimited access to telehealth consultations for a monthly fee.

However, there may be limitations like the specific types of care covered, requiring initial in-person visits, or capping the number of telehealth visits. Recently, many private insurers have started providing telehealth services through third-party platforms like Teladoc or AmWell (Healthcare Service Corporation, 2020).

Medicare and Medicaid

Medicare Part B covers certain telehealth services, including virtual visits with doctors and specialists (Medicare.gov, n.d.). Medicaid coverage for telehealth varies by state, but many states have expanded their telehealth benefits in recent years (Schwamm et al., 2017).

Employer-sponsored plans

People sitting in an auditorium for a presentation

Many employers offer health insurance plans that include telehealth services. These plans often come with additional benefits like mental health services and secure messaging with healthcare providers.

With various telehealth insurance options available, it’s important to know what features to consider when evaluating plans.

What to Look for in Telehealth Insurance Plans

Choosing the right telehealth insurance plan can be overwhelming. Here are some key features to consider.

Scope of covered services

Ensure the plan covers a wide range of services, including:

  • Primary Care: Regular check-ups and preventive care. Many plans cover virtual visits for routine health assessments.

  • Mental Health: Access to telepsychiatry and counseling services. Mental health services via telehealth can be as effective as in-person visits.

  • Specialist Consultations: Ensure the plan includes virtual visits with specialists like cardiologists, and dermatologists. This can save time and reduce the need for physical referrals.

Network of available providers

A robust network of in-network providers ensures that you have access to a variety of healthcare professionals without incurring additional costs. Check if the plan includes:

  • Local Providers: Access to local healthcare providers who offer telehealth services.

  • Specialists: A wide range of specialists are available for virtual consultations.

  • National Networks: Some plans offer access to national networks of providers, which can be beneficial if you travel frequently.

Cost-sharing 

Bottle of pills spilled on currency

Healthcare marketplaces offer affordable individual health insurance plans. These plans must meet standards for cost-sharing, which are the out-of-pocket expenses people pay for medical services. 

Cost-sharing typically includes deductibles, copayments, and coinsurance, though not all plans use all three types (Rakshit et al., 2023):

  • Copayments: The fixed amount you pay for each visit. The fixed amount you pay for each telehealth visit. Some plans may offer lower copayments for virtual visits compared to in-person visits.

  • Deductibles: The amount you need to pay out-of-pocket before the insurance starts covering services. You may want to pair a high-deductible plan with Health Savings Accounts (HSAs) to help manage costs.

  • Coinsurance: The percentage of costs you share with the insurance company after you’ve paid your deductible. For example, a plan might cover 80% of the cost, leaving you to pay the remaining 20%.

Technology platforms and user experience

The technology with a telehealth platform should be easy to use. Look for features like:

  • User-Friendly Interface: An intuitive and easy-to-use platform.

  • 24/7 Availability: Access to healthcare services at any time.

  • Short Wait Times: Minimal waiting period for consultations.

Quality of care

Nursing colleagues in hall wearing blue

While convenience is a significant factor, the quality of care should not be compromised. Look for plans that ensure (Wolters Kluwer, 2023):

  • Clinical Effectiveness: The platform should support high-quality care across different specialties like chronic conditions and mental health issues.

  • Access to Resources: Plans that provide easy access to educational resources can empower patients to take control of their health.

Several insurance companies offer telehealth coverage, each with its own features and benefits. Here’s a comparison of some popular providers in the following table with info from the Center for Connected Health Policy (2021).

ProviderProsConsUnique FeaturesCustomer Satisfaction
AetnaComprehensive coverage & wide networkHigher premiumsIntegration with CVS HealthHigh
Blue Cross Blue ShieldBroad coverage & various plan optionsVaries by stateSpecialized telehealth programsHigh
Kaiser PermanenteIntegrated care model & user-friendly appLimited to certain regionsSeamless care coordinationVery High
UnitedHealthcareExtensive provider network & 24/7 availabilityComplex cost-sharingVirtual health assistantsModerate

Studies show patients prefer video telehealth over audio-only, reporting higher satisfaction and better outcomes. Video telehealth users are less likely to need emergency or in-person care (Lee et al., 2023). 

Armed with knowledge about different plans and their key features, let’s learn how to pick the best telehealth insurance plan for your needs.

How to Choose the Right Telehealth Insurance Plan for You

Doctor and patient virtual meeting both male

Selecting the right telehealth insurance plan requires careful consideration of your healthcare needs and preferences. Here are some steps to guide you.

Assess your healthcare needs

Identify your healthcare needs and preferences. Consider the following questions:

  • Do you need frequent specialist consultations?

  • Are mental health services important to you?

  • Do you have any chronic conditions that need regular monitoring?

Evaluate costs

Consider your budget and review the costs associated with each plan, including premiums, copayments, and deductibles.

  • Premiums: The monthly cost of the insurance plan.

  • Out-of-Pocket Costs: Copayments, deductibles, and coinsurance. For example, Medicare Part B covers certain telehealth services after you’ve paid the deductible, with a 20% coinsurance.

  • Additional Fees: Any additional fees for using telehealth services, such as subscription fees for standalone telehealth plans.

Check provider networks

Ensure the plan has a network of providers that includes your preferred doctors and specialists. This can help you avoid out-of-network charges and ensure continuity of care.

Review policy terms

Med insurance policy paper

Read the policy terms and conditions carefully. Look for any exclusions or limitations on telehealth services (Upvio, n.d.). For example, some plans may limit the number of telehealth visits they cover per year.

Consider integration with an existing plan

If you already have a health insurance plan, check if the telehealth plan works seamlessly with your existing coverage to provide a more comprehensive healthcare solution.

Tips to Maximize Your Telehealth Insurance Benefits

Once you have chosen a telehealth insurance plan, here are some tips to get the most out of it.

Medicare card and Rx closeup

Understand your coverage limits

Know the limits and restrictions of your coverage. This includes the number of visits covered and any specific conditions that apply (Upvio, n.d.). For example, some Medicare Advantage Plans offer more telehealth benefits than Original Medicare. 

Prepare for virtual appointments

Prepare for your virtual visit. Get your medical history and questions ready. Ensure you have a stable internet connection and a quiet, private space for the consultation.

Keep records

Maintain records of your telehealth visits and expenses to help you track your healthcare costs and manage your budget. Keeping detailed records can also be useful for any follow-up care or claims disputes.

Communicate effectively

Effective communication with your healthcare provider is key. Be clear about your symptoms and concerns. Beyond calling, you can use secure messaging within your patient portal to ask follow-up questions or clarify any doubts.

Stay informed

Keep track of any updates to your policy. Insurance plans can change, and staying informed ensures you continue to receive the best care. Check for updates from your insurance provider regularly, and review any new benefits or changes in coverage.

Use available resources

Take advantage of any educational resources provided by your telehealth platform. These resources can help you better understand your health conditions and treatment options, and empower you to make informed decisions about your care.

Conclusion

Telehealth insurance options have expanded significantly, providing us with more flexibility, convenience, and access to virtual care. However, navigating telehealth insurance options can be complex. By understanding the various plans available and considering your unique healthcare needs, you can select a telehealth insurance option that provides comprehensive coverage and peace of mind. 

Remember to review your policy on a regular basis and stay informed about new developments in telehealth insurance. Over time, insurance coverage will likely adapt their virtual care options to meet our changing healthcare needs. Take the time to explore your options and make an informed decision to ensure you’re getting the most out of your telehealth insurance coverage.

References

An Analysis of Private Payer Telehealth Coverage. (2021). Center for Connected Health Policy. Retrieved from https://www.cchpca.org/2021/04/Private-Payer-Telehealth-Coverage-Reportfinal.pdf

Bestsennyy, O., Gilbert, G., Harris, A. & Rost, J. (2021). McKinsey & Company. Retrieved from https://www.mckinsey.com/industries/healthcare/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality

Centers for Medicare & Medicaid Services. (n.d.). Telehealth. Medicare.gov. Retrieved from  https://www.medicare.gov/coverage/telehealth

Cordina, J., Levin, E., Stein, G.  (2022). Consumer Health Insights: How respondents are adapting to the “new normal.” McKinsey & Company. Retrieved from https://www.mckinsey.com/industries/healthcare/our-insights/covid-19-consumer-healthcare-insights-what-2021-may-hold

Cost-Sharing Charges. (2023). Center on Budget and Policy Priorities. Retrieved from https://www.healthreformbeyondthebasics.org/cost-sharing-charges-in-marketplace-health-insurance-plans-answers-to-frequently-asked-questions/

Cuellar, A., Pomeroy, J. M. L., Burla, S., Jena, A. B. (2022). Outpatient Care Among Users and Nonusers of Direct-to-Patient Telehealth: Observational Study. Journal of Medical Internet Research;24(6):e37574. doi:10.2196/37574 

Five key features telehealth patients want: Insights for healthcare developers. (2023). Wolters Kluwer. Retrieved from https://www.wolterskluwer.com/en/expert-insights/5-key-features-telehealth-patients-want-healthcare-developers-insights

Hasselfeld, B. W. (n.d.). Benefits of Telemedicine. Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine

How to Check Telehealth Insurance Coverage. (n.d.). Upvio. Retrieved from https://upvio.com/blog/telehealth/how-to-check-telehealth-insurance-coverage

Lee, E. C., Grigorescu, V. Enogieru, I., Smith, S. R. Samson, L. W., Conmy, A. B., & De Lew, N. (2023). Updated National Survey Trends in Telehealth Utilization and Modality (2021-2022). Assistant Secretary for Planning and Evaluation (ASPE). Retrieved from  https://aspe.hhs.gov/sites/default/files/documents/7d6b4989431f4c70144f209622975116/household-pulse-survey-telehealth-covid-ib.pdf

Private insurance coverage for telehealth. (2023). Health Resources & Services Administration (HRSA). Retrieved from https://telehealth.hhs.gov/providers/billing-and-reimbursement/private-insurance-coverage-for-telehealth 

Rakshit, S., Rae, M., Claxton, G., Amin, K., & Cox, C. (2023). Private Insurer Payments for Telehealth and In-Person Claims During the Pandemic. Kaiser Family Foundation. Retrieved from  https://www.kff.org/mental-health/issue-brief/early-in-the-pandemic-private-insurers-paid-similarly-for-common-telehealth-and-in-person-claims/

Schwamm L.H., Chumbler N., Brown E., et al. (2017). Recommendations for the implementation of telehealth in cardiovascular and stroke care: a policy statement from the American Heart Association. Circulation;135(7):e24–e44. doi: 10.1161/CIR.0000000000000475

Stay Informed on COVID-19. (2020). Health Care Service Corporation. Retrieved from  https://www.hcsc.com/newsroom/category/company-news/covid-19-information/