Convenience vs Cost: Cash-Based Virtual Visits Growing Nationally

10-15-2013 12-15-59 PM

American Well, a growing telemedicine company, launches a new virtual visit service that connects patients at home with a physician online for a video consultation. The cash-based service is available to the insured and uninsured alike, and will be available in 44 states plus DC 24 hours a day, 365 days a year. Visits cost $49, more than the average office visit co-pay, but less than the average co-pay for an urgent care or emergency department visit.

On American Well’s website, visitors can browse doctors’ profiles and schedule an appointment with whoever they’d like. Alternatively, they can receive immediate care by accepting the next available physician who would be able to address their condition. The platform is manned by 700 physicians, spanning the nation. Physicians come from on-call practice docs that set aside time to take virtual visits, independent doctors who make themselves available on an as-needed basis, and doctors from Online Care Group, self described as “the nation’s first physician-owned primary and urgent care group devoted to video telehealth.”

The physicians are able to see patients for simple conditions like the flu or urinary tract infections. They are also able to prescribe drugs other than controlled substances. When the visit is over, the encounter is documented and sent via the Surescripts network to the patient’s PCP.

American Well has been providing telehealth services through payers and large employers for the past year and a half. It counts WellPoint, United, Blue Cross, and many large employers as its customers. The decision to offer telehealth services to the general public is in line with a broader trend in the telehealth space. In smaller pilot programs launched regionally, consumers have started demonstrating that there is demand for cash-based healthcare services if the quality is equivalent and the cost is not significantly higher. A recent BBC Research study forecasts that telehealth will be a $27 billion industry by 2016, triple its current size.

Last month, KentuckyOne Health, Kentucky’s largest health care system, announced that it would begin offering $35 virtual visits for Kentucky residents starting November 1. The new service will be staffed by physicians from Carena Inc., a Seattle-based telehealth company. The hope is that the platform will provide a cost-effective alternative to unnecessary ER visits for uninsured patients who need to see a doctor. Insured patients may also opt for a virtual visit solely for the convenience. The service will also helps address local physician shortages in Kentucky.

There is value to ‘”seeing” a doctor while staying when you are sick. Or as any parent knows, to being able to consult with a pediatrician in the middle of the night without having to get everyone dressed and drive to the ER. As telehealth platforms become more user friendly and integrated with existing care delivery channels, patients are actively proving that enough of them are willing to embrace the new format to make it a financially viable care delivery option.

American Well says that the decision to offer cash-based services to the public was an easy one to make because most insurance companies do not yet offer their customers telehealth, so there is a large market of consumers that could only participate if a cash-based option were available.


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