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Doctors' Virtual Consults With Patients To Double By 2020
Doctors' Virtual Consults With Patients To Double By 2020
Bruce Japsen : Forbes
Thanks to expanding health insurance coverage, the number of virtual video consultations between primary health care providers and their patients will double in five years in the U.S., fueling the nation’s telehealth boom,according to a new analysis.
A new report from information and analytics firm IHS says video consultations will jump overall to nearly 27 million in the U.S. market, driven by the primary care market where insurance coverage is rapidly widening. IHS IHS projects there will be cumulative annual growth of nearly 25% a year over the next five years to 5.4 million video consultations between primary care providers and their patients by 2020 from this year’s 2 million video consultations, IHS says.
“We’ve seen growth in reimbursement,” Roeen Roashan, medical technology analyst with IHS said in an interview. “There’s no doubt payers are focused on virtual consultations. They are really pushing it.”
Health plans see a way for patients to get high quality care from a physician and the potential to avoid a more expensive trip to a hospital emergency room. It also may be a way to get a quick answer from a doctor about an existing treatment regimen.
“The direct cost of nonadherence to doctors’ advice is estimated at $100 billion to $289 billion annually,” according to a new report from researchers studying virtual healthcare at the University of California, San Franciscoworking with the Stanford University Graduate School of Business.
To be sure, major health plans like Aetna (AET), Anthem (ANTM), Cigna (CI) and UnitedHealth (UNH) are expanding coverage and offering more options to employer clients.
Earlier this year, UnitedHealth announced plans to roll out “virtual doctor’s visits” to nearly 1 million health plan members in self-funded plans that will have access to an array of provider networks including Doctor on Demand,Now Clinic and American Well. Other insurers are using similar vendors as well as MDLive, which has a relationship with health plans and Walgreens Boots Alliance (WBA).
Total numbers of virtual consults is growing 10% a year with 16.6 million this year with growth projected to hit 26.9 million including consultations with specialists in many fields including mental health and dermatology. Specialty consultations are projected to jump from 14.5 million to 21.5 million, IHS figures show.
Much, however, needs to be done to meld virtual consultations into the health care system, analysts say, as the Affordable Care Act and insurers move providers to a more coordinated approach that is value-based and moves away from traditional fee-for-service medicine.
Much, however, needs to be done to meld virtual consultations into the health care system, analysts say, as the Affordable Care Act and insurers move providers to a more coordinated approach that is value-based and moves away from traditional fee-for-service medicine.
“Even though more and more people use online urgent care for $49, there won’t necessarily be an improvement of healthcare until providers integrate virtual consultations as part of their care delivery,” Roashan says. “This will allow a much more intimate experience and most likely at a lower cost than $49. We’ve seen large providers providing complimentary virtual consults for their patient population, and . . . that’s the model we need to see more of.”
This is what's driving premium hikes
This is what's driving premium hikes
Aug 06, 2015 | By Jack Craver : Benefits Pro
Despite widespread news about changes in health care premiums brought on by the Patient Protection and Affordable Care Act, most of us are in the dark as to what is driving some of the wild variations in premium rates across the country.
According to a report by the American Academy of Actuaries, the major drivers of premium hikes are linked to insurers' uncertainty in the future of their plans.
As always, premium growth is related directly to growth in overall health care spending, including medical services and prescription drugs. However, the report notes, the recent economic downturn and recent initiatives to move away from the prevailing fee-for-service system of medical care might be gradually slowing the rate of premium increases.
In addition, as insurers are slowly adapting to the PPACA world, they are still reworking their assessments of the risk pools created by PPACA health plans. That may be good news or bad news for consumers.
"With another year of experience, insurers have gained more information regarding the risk profiles of their enrollee populations and how these compare to the profiles for the market as a whole, and will adjust their premiums accordingly," states the report.
While the initial enrollees in PPACA plans tended to be higher-risk, older individuals, the Obama administration has recently touted increased numbers of young people enrolling in plans, which should result in lower premiums.
In addition, the federal government plans to eventually phase out a transitional reinsurance program designed to help participating insurers pay for especially high claims. The fund, which insurers pay into and which covers the cost of claims between $45,000 and $250,000, is scheduled to sunset after 2016. Insurers might respond by raising premiums.
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Drugstore Doctors By Marissa Evans, CQ Staff
Drugstore Doctors
By Marissa Evans, CQ Staff
Pharmacists in California and Oregon will soon be able to prescribe birth control to women right over the counter, encroaching on another medical service that was once the exclusive province of doctors.
The two states will be the first in the country to allow pharmacists to prescribe contraceptives on their own, without a doctor’s prescription.
California legislators passed their bill in 2013 and the law goes into effect Oct. 1. Oregon Gov. Kate Brown, a Democrat, signed her state’s bill July 6 and it takes effect Jan. 1.
The two laws are part of a broader trend in states seeking efficiencies in health care as more residents become insured and doctors struggle with increased demands for their services. For instance, 21 states and the District of Columbia have given nurse practitioners the ability to practice without doctor supervision.
Krystalyn Weaver, director of policy and state relations for the National Alliance of State Pharmacy Associations, says pharmacists receive universal training in pharmacology school but most states don’t take advantage of that experience. “Pharmacists are very highly trained and that education is focused on optimizing drug therapy to make health outcomes as good as they can be,” Weaver says. “It does take time, not everyone is meant to be on certain kinds of birth control. There’s some brainwork involved with prescribing medication.”
The expansion of authority for pharmacists in California and Oregon, as well as greater roles for nurse practitioners in other states, have drawn criticism from physicians who argue that only they have the proper training to prescribe certain medications or provide primary services. Others, they say, should be required to give such care only under a doctor’s supervision.
“The American Medical Association encourages physician-led health care teams that ensure health care clinicians work together as the ideal way to provide high quality and efficient care,” the organization said in an email statement. “Innovative physician-led team models across the country are achieving improved care and patient health, while reducing costs. Pharmacists are valuable members of this team, and patients win when each member of their health care team plays the role they are educated and trained to play.”
Oregon and California are “trying to bring pharmacists more into the fold of utilizing their skills,” says John Norton, director of public relations for the National Community Pharmacists Association. “Pharmacists are the most accessible health care provider out there. You can drop by anytime you want and get your services.... It makes health care more accessible and easier to do from a patient perspective.”
California’s new law allows pharmacists to get additional training to prescribe contraceptives and establishes new training and licensing standards for “advanced practice pharmacists.”
Oregon’s bill allows pharmacists to prescribe birth control medication and devices to women and amends the definition of “practice of pharmacy” in the licensing statutes to include prescribing such products.
Even as California prepares for the law to go into effect in October, questions loom regarding the kind of training pharmacists will have to complete, how consumers will find advanced practice pharmacists, whether consumers will pay more to pharmacists for counseling and whether such fees will be covered by insurance companies.
Other states will be watching the two states closely, says Elizabeth Nash, senior state issues associate at the Guttmacher Institute, a nonprofit that advocates for reproductive health services.
“We haven’t seen it implemented, so it’s hard for other states to envision how it would work in their state,” Nash says. “We’re going to have two examples and there might be momentum to see if this is an option for them. Once you have a couple of examples, people want to take a wait-and-see approach so they have an idea of what to expect and how to make it a smooth process.”
Pharmacists in other states do have some experience with contraceptives. A Guttmacher report last month found that Alaska, California, Hawaii, Massachusetts, New Hampshire, Vermont and Washington allow pharmacists to provide emergency contraception without a prescription when acting under a collaborative-practice agreement with a physician. California, Maine and New Mexico allow pharmacists to do so under state-approved protocols.
Arizona, Arkansas, Georgia, Idaho, Mississippi and South Dakota are among states that allow pharmacists to refuse to give contraceptives, including emergency contraception.
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