Telemedicine: A Prescription For Lower Health-Care Costs?

View of a computer station for MeMD online exam at the office.
Souce: MeMD
View of a computer station for MeMD online exam at the office.

Like its small business clients, Payroll Experts struggles with the ever-rising price of employee health insurance. The Scottsdale, Ariz., company also knows how much its productivity dips when one of its 21 staffers gets a sore throat and has to leave work to go to a doctor’s office or clinic during its quarterly busy seasons.

But at Payroll Experts, workers have another option. They can sit in front of a computer with a webcam and quickly get an online medical exam by an urgent-care nurse practitioner and, if needed, get a prescription sent to a nearby pharmacy.

“Employees often can’t get a quick appointment at their primary doctor and end up going to urgent-care clinics. Now they use the online exam as a convenient alternative,” says Alexia Matak, director of marketing at Payroll Experts. Along with the convenience, fewer urgent care visits keep the company’s health insurance premiums down, she says. Employees have typically had ailments such as sinus or bladder infections, allergies and skin irritations diagnosed via an online exam.

Even as the Supreme Court on Thursday upheld the individual mandate portion of Obamacare — paving the way for making health care available to uninsured Americans — the fact remains that health-care costs for employers and their workers remain expensive and difficult to manage.

The virtual exams are offered by MeMD, an online health-care service that provides online medical visits in 30 states. It charges $35 to $40 per exam, often split by employer and employee, plus a monthly fee of $1 to $2 per employee paid by the employer. If the same employee were to visit a doctor’s office, they would pay more than $40 as a co-pay. An uninsured employee would pay much more.

During the first quarter of 2012, the Payroll Experts staff logged seven MeMD visits, and the company estimates it saved $740 from reduced medical fees and lost staff hours.

Online, on-demand health exams are part of an emerging industry called telemedicine. It uses phones, websites, email, webcams and other communications technology to care for patients who are not in the same location as the medical provider. According to BCC Research, the global telemedicine market grew from $9.8 billion in 2010 to $11.6 billion in 2011, and will hit $27.3 billion in 2016.

Goodman’s Interior Structures, based in Arizona, has been offering MeMD’s service to its 150 on-site and remote employees and their families since January. Recently, a staff member’s spouse was sick at home and didn’t have a car, says Brian Turner, Goodman’s human resource director.

“Ordinarily our staffer would have to leave work to take the family member to urgent care. But this time the sick spouse used a computer, webcam and phone at home to communicate with the nurse practitioner and get an online diagnosis and prescription, which the staffer picked up at the drug store on his way home after work,” he says. Before signing up with the online service, “we found that our people had been using urgent care a lot,” notes Goodman. To encourage employees to try the online exams, the company gives them a $25 rebate to help cover the cost of their first exam.

"Virtual care can be instrumental in fixing our current state of affairs within the health care system." -co-founder, NowDox, Robert L. Smith

Ian Vasquez, chief operating officer at MeMD, says companies that provide traditional health insurance find that adding MeMD on-demand medical care typically saves them $400 a year per employee, thanks to less absenteeism and lower insurance premiums. Usually the more frequently that employees use expensive urgent care clinics and emergency rooms, the higher the employers’ insurance premiums. For the growing number of small businesses that offer high-deductible health insurance, the virtual exams can cover medical visits that their health insurance doesn’t cover.


Virtuwellis a similar online medical service that operates in Minnesota and Wisconsin. Patients who use the service fill out forms online describing symptoms. Nurse practicioners text or email a diagnosis and treatment plan. About 80 percent of Virtuwell patients have health insurance.

While Virtuwell, a division of Health Partners, bills patients directly, it works with employers to provide education materials to acquaint workers with its offerings. “Small companies call us, asking how they can get their employees to take advantage of our exams, so we give them posters, video and mailers,” says Kevin Palattao, vice president.

Patients seem happy with the results. Virtuwell’s Palattao says about 95 percent of patients report that they saved two or more hours compared to an in-person exam, and 98 percent would highly recommend the service to their friends. At Payroll Experts, all seven employees that have used the MeMD online medical service highly recommended it to their colleagues.

Regulations governing online medical exams vary from state to state. Some states, such as Texas, require an in-person visits with a medical provider before allowing online visits.

But those limitations may change. Virtuwell execs say that thanks to assertive employers, more insurance carriers are covering virtual health exams.

"Virtual care can be instrumental in fixing our current state of affairs within the health-care system,” says Robert L. Smith, a family doctor and co-founder of NowDox, a telemedicine consultancy based in Canandaigua, N.Y. “We believe that empowering people to decide how they will receive care is a much better model for patient treatment."

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