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

How Health Apps Promote Preventive Care and Early Disease Detection

How Health Apps Promote Preventive Care and Early Disease Detection

by Ree AI Health Tech

Health apps have become powerful tools for preventive care and early disease detection. From tracking daily habits to advanced symptom checkers, these apps have made it much easier to manage our health, putting vital information and monitoring capabilities right at our fingertips. 

Let’s see how these innovative health apps promote preventive care, empowering users to take proactive steps towards better health outcomes.

Contents

Preventive Care and App Usage

Preventive Care sign and stethoscope

Health apps play a crucial role in preventive care by empowering people to take a proactive approach to manage their health. They include features to monitor vital signs, track fitness goals, and assess disease risks–all from the convenience of a smartphone.

Before we discuss how health apps promote preventive care, let’s define and review that concept.

What is preventive care?

Preventive care refers to routine healthcare services aimed at preventing illnesses and detecting health issues before they become serious. This includes regular check-ups, vaccinations, screenings, and lifestyle counseling. 

Focusing on prevention can help people stay healthier, save money, and catch issues early when they’re more treatable. Preventing diseases is often easier and more cost-effective than treating them. 

Growth of health app market in recent years

The health app market isn’t just growing; it’s booming. With over 300,000 health apps available and about 200 new ones released daily, we have a vast array of options available anytime. 

As of 2023, there’s been over 200 million diet and nutrition app downloads, and 20% of Americans use wearable devices integrated with health and fitness apps. This growth is driven by increasing smartphone usage, rising awareness about health and fitness, and the convenience these apps offer.

The health app market has seen explosive growth in recent years. In fact, the global mHealth apps market size was estimated at USD 32.42 billion in 2023 and is anticipated to grow at a compound annual growth rate (CAGR) of 14.9% from 2024 to 2030. 

This surge reflects a big shift in healthcare from reactive treatment to proactive prevention.

Key features of successful preventive care apps

What makes a preventive care app successful? The most effective apps share some common features:

  • User-friendly interfaces

  • Personalized health recommendations

  • Integration with wearable devices

  • Data visualization tools

  • Social sharing capabilities

  • Regular updates based on the latest health guidelines

These features help users stay engaged and motivated in their health journey.

Woman with headphones stretching before a run outside
Source: Styled Stock Society

Who’s using these apps? While health apps appeal to a broad audience, certain demographic trends are emerging. 

A study found that 84 million people in the U.S. used healthcare apps to monitor their health-related activities in 2022. Millennials and Gen Z lead the charge in health app adoption, with a particular focus on fitness and mental health apps.

Apps for Health Monitoring and Tracking

As health apps continue to grow in popularity, let’s explore some of the most popular categories and how they’re helping users monitor their health.

Apps to track vital signs 

Purple pulse oximeter and mask

Vital sign tracking apps have become increasingly sophisticated. Many can now measure heart rate, blood pressure, and even blood oxygen levels using just a smartphone camera or with wearable devices. 

For example, the Cardiio app uses a smartphone camera to measure heart rate with 97% accuracy compared to clinical pulse oximeters.

Apps to monitor sleep patterns and quality

Older woman asleep wearing smartwatch next to cell phone

Poor sleep can increase your risk of various health issues. 

Sleep tracking apps help users understand their sleep patterns and quality. Apps like Sleep Cycle use your phone’s microphone and accelerometer to analyze your sleep stages and wake you up during your lightest sleep phase.

Apps for nutrition and diet tracking 

Measuring tape with grapes apples phone

Maintaining a healthy diet is crucial for preventive care. Nutrition apps like MyFitnessPal allow users to log their food intake, track calories, and monitor nutrient balance. These apps often include extensive food databases and barcode scanners for easy logging.

Physical activity and fitness monitoring

Fitness apps have come a long way from simple step counters. Apps like Strava or Nike Run Club can track various activities, provide workout plans, and even offer virtual coaching. Many integrate with wearable devices for more accurate data collection.

Man with sarcopenia and a cane

One study of older adults found that the Sit to Stand app can detect older adults with both frailty/pre-frailty and sarcopenia (Montemurro et al., 2024). The app was very accurate, with an 80-92% success rate. People the app identified with both frailty and sarcopenia were more likely to have other health problems like falls, hospitalization, depression, and low income. 

Early Detection: Symptom Checkers and Risk Assessment Apps

One of the most exciting developments in health apps is their potential for early disease detection. Let’s look at how these apps are helping users identify potential health issues early.

Symptom checker apps like Ada or WebMD Symptom Checker allow users to input their symptoms and receive potential diagnoses. While these apps shouldn’t replace professional medical advice, they can help users decide whether to seek medical attention. 

A study of 22 symptom checker apps had low average diagnostic accuracy rates, highlighting the need for continued improvement in this area (Schmieding et al., 2022).

Risk assessment tools for common diseases

Many apps now offer risk assessment tools for common diseases like diabetes, heart disease, or certain cancers. These tools typically use questionnaires about lifestyle factors, family history, and sometimes integrate data from other health tracking features to provide a personalized risk assessment.

Elderly woman with pills and a walker

A UK study by Reid et al. (2024) looked at how well older adults could use a digital test for dementia risk and brain function. The test was easy for participants to complete. 

Age affected all brain tests, while gender and education only impacted verbal skills. Women and those with more education did better on word-related tasks. Age was linked to lower scores on all tests, which matches what we know about aging and brain health, and could help spot early signs of brain decline.

AI-powered apps for skin cancer detection

Skin cancer detection apps are a prime example of how AI is enhancing early detection capabilities. 

Man examining a skin lesion on his arm

Apps like SkinVision use machine learning algorithms to analyze photos of skin lesions and provide a risk assessment. A study found that SkinVision had a 95.1% sensitivity in detecting malignant skin lesions (Smak Gregoor et al., 2023).

Mental health screening and mood tracking applications

Mental health apps are playing an increasingly important role in early detection of mental health issues. Apps like Moodfit or Daylio allow users to track their mood over time, potentially identifying patterns that could indicate underlying mental health concerns.

Integrating Health Apps with Healthcare Systems

The real power of health apps lies in their ability to integrate with broader healthcare systems. This integration is transforming how we interact with healthcare providers and manage our health data.

Apps that connect users with healthcare providers

Telehealth apps like Teladoc or Doctor On Demand allow users to consult with healthcare providers remotely. These apps have become particularly valuable during the COVID-19 pandemic, providing safe access to medical advice.

Electronic health record integration capabilities

Some health apps can now integrate with electronic health records (EHRs), allowing for seamless sharing of health data between patients and healthcare providers. This integration can lead to more informed medical decisions and better continuity of care.

Telehealth features in preventive care apps

Many preventive care apps now include telehealth features, allowing users to share their health data directly with healthcare providers and receive personalized advice. This integration of tracking and consultation features creates a more comprehensive health management experience.

Data sharing and privacy considerations

With the increasing amount of health data being collected and shared, privacy concerns are paramount. 

Health apps must comply with regulations like HIPAA to protect user data. Users should always review an app’s privacy policy and understand how their data will be used and protected.

Conclusion

Health apps for preventive care and early detection are more than just trendy tools–they’re becoming essential allies in our quest for better health. Putting the power of prevention in our pockets, these apps can help users spot potential issues early, track important health metrics, and make informed decisions about their well-being. 

While health apps are valuable, they should complement professional medical advice–not replace it. Don’t wait for a health problem to arise. Start exploring these apps, and take the first step towards a healthier, more proactive lifestyle.

References

8 Types of Preventive Care to Ensure Health Life for Seniors. (2022). EliteCare Health Centers. Retrieved from https://www.elitecarehc.com/blog/8-types-of-preventive-care-to-ensure-healthy-life-for-seniors/

Deb, T. (2024). Diet and Nutrition Apps Statistics 2024 By Tracking, Health and Wellness. Market.us Media. Retrieved from https://media.market.us/diet-and-nutrition-apps-statistics/

Deb, T. (2024). Home Gyms in Your Pocket: The Fitness App Market is on Fire, Reaching USD 4.9 Billion in 2023. Market.us Media. Retrieved from https://media.market.us/fitness-app-market-news/

Grand View Research. (2023). mHealth Apps Market Size, Share & Growth Report, 2030. Retrieved from https://www.grandviewresearch.com/industry-analysis/mhealth-app-market

Gupta, I. (2024). Trends in Telemedicine App Development 2024. iMark Infotech. Retrieved from https://www.imarkinfotech.com/trends-in-telemedicine-app-development-2024/

Jayani, P. (n.d.). The Ultimate Guide to EHR Integration for Mobile Health Apps. Blue Whale Apps. Retrieved from https://bluewhaleapps.com/blog/the-ultimate-guide-to-ehr-integration-for-mobile-health-apps

mHealth Apps Market Size | share and Trends 2024 to 2034. (2024). Precedence Research. Retrieved from https://www.precedenceresearch.com/mhealth-apps-market

Montemurro, A., Rodríguez-Juan, J. J., Martínez-García, M., & Ruiz-Cárdenas, J. D. (2024). Validity of a video-analysis-based app to detect prefrailty or frailty plus sarcopenia syndromes in community-dwelling older adults: Diagnostic accuracy study. DIGITAL HEALTH. doi.org/10.1177/20552076241232878

Reid, G., Vassilev, P., Irving, J., Ojakäär, T., Jacobson, L., Lawrence, E. G., Barnett, J. Tapparel, M., & Koychev, I. (2024). The usability and reliability of a smartphone application for monitoring future dementia risk in ageing UK adults. The British Journal of Psychiatry; 224(6):245-251. doi:10.1192/bjp.2024.18

Schmieding, M., Kopka, M., Schmidt, K., Schulz-Niethammer, S., Balzer, F., Feufel, M. (2022).

Triage Accuracy of Symptom Checker Apps: 5-Year Follow-up Evaluation. Journal of Medical Internet Research; 24(5):e31810, doi.org/10.2196/31810

Smak Gregoor, A. M., Sangers, T. E., Bakker, L. J., Hollestein, L., A., C., Nijsten, T., & Wakkee, M. (2023). An artificial intelligence based app for skin cancer detection evaluated in a population based setting. Npj Digital Medicine, 6(1), 1-8. doi.org/10.1038/s41746-023-00831-w

What is Preventive Care? (2018). ConnectiCare. Retrieved from https://www.connecticare.com/live-well/blog/wellness-and-prevention/whats-preventive-care

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

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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

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