Future Tense

Take Two and Skype Me In The Morning

Your next checkup might take place in virtual reality.

Photo by Bay Ismoyo/AFP/Getty Images

The country’s largest health insurer is putting telemedicine on par with a regular trip to the doctor’s office, effectively saying a video visit is as good as brick-and-mortar medicine.

UnitedHealthcare announced on April 30 a partnership with three telemedicine companies to cover video-based doctor visits just as it covers in-person visits. The tech set has for decades predicted that we would one day get our medical care via video chat, but it wasn’t until recently that forward-thinking physicians started taking the promise of telemedicine seriously. The decision by so influential a player in the  health care industry to telemedicine is the strongest sign yet that the technology is entering the mainstream.

United says it will cover virtual doctor visits offered through NowClinic, Doctor on Demand, and American Well. These platforms connect patients with thousands of doctors—albeit not the patient’s usual doctor—via video chat. These consultations typically cost $40 to $50 a pop, but now that United is covering these visits, members will only have to pay their usual co-pay, making virtual medicine much more affordable for more people. For now, these virtual visits will be available only to UnitedHealth’s self-funded customers, but the feature will expand to most members by next year.

According to Peter Mueller, a health care industry analyst at Forrester, United’s embrace of doctor visits by video is a major step for the healthcare industry. “There are a lot of pros to telemedicine,” he says. “Convenience is one. Access is another. Then there’s the immediacy of it, too.”

In a statement, the insurer said the goal is to give people, especially those in rural areas, access to affordable quality care. Telemedicine providers said the deal validates their approach to medicine. “The consumer may not have known if we were going to help or if they’d have go to urgent care anyway,” says Adam Jackon, CEO of Doctor on Demand, who says the app has been downloaded 1 million times in 18 months. “Now that we’re part of United, it’s like, ‘Ok, United stuck their neck out and vetted these guys.”

Of course, helping others isn’t the only motivation. By offering telemedicine services, health insurers stand to substantially lower their costs, because virtual visits are significantly cheaper than urgent care or even primary care visits. Much as online retailers did to brick-and-mortar shopping, telehealth companies have used technology to eliminate most of the overhead that contributes to the high cost of health care.

And United is not the only company that’s noticed. Newer insurers like Oscar as well as established ones like WellPoint and some BlueCross BlueShield plans have also adopted telemedicine programs in recent years.

Another contributing factor to the move toward telemedicine is the Affordable Care Act. As people look to exchanges for insurance, they’re better able to shop around for insurers who promise to deliver more perks, says Mueller. “Now, these carriers are up on the shelf with other carriers,” he says. “And in the business-to-consumer world they need to offer people a lot more.”

Then there’s the fact that the Affordable Care Act brought many more people into a health care system already facing a shortage of primary care physicians. According to Jackson, virtual visits can help hospitals and urgent care centers offload some of their more easily treated cases in order to focus on patients who really need in-person care. “These visits keep the colds and flus and allergies and bumps and bruises out of the offline settings,” Jackson says. “That frees up the waiting rooms, so doctors can treat more pressing issues.”

Still, telemedicine will only take off with insurers’ support if patients actually trust their insurance companies, which far too many Americans do not. There will be those who view what United is doing as an attempt to cut costs at the expense of more personalized care. But Mueller says that type of criticism misses one important point: “It’s not mandated, so if it’s not for you or you don’t trust it, you have other options.”

Jackson, for one, says Doctor on Demand’s biggest users are working mothers, who have lots of questions about their kids’ health but can’t take a day off of work to bring them to the doctor whenever they have the sniffles. Instead, they can fire up their phones, wait a couple minutes, and have access to one of 1,400 licensed physicians who can provide them with a diagnosis and a prescription all by video. According to Jackson, around 92 percent of cases on Doctor on Demand require no in-person follow up.

And this type of telemedicine treatment is only the beginning, says Dr. Roy Schoenberg, CEO of American Well. Already, his company has been working with large hospital systems like Cleveland Clinic and Massachusetts General, which have been using their technology to treat even serious conditions like cancer and heart disease.

“These organizations are beginning to understand that the care they can extend to you can be dramatically different if they can continuously see you at home, when you’re undergoing long-term treatment,” Dr. Schoenberg says. He expects this type of use case to grow. Meanwhile, he says we may soon see a day when services like American Well can connect you not just to any old doctor, but to your own doctor.

That type of around-the-clock care may take a while to catch on, but Dr. Schoenberg says that the United partnership will help nudge these ideas forward. “It really cements the place of technology-based healthcare in commercial markets,” he says. “And we strongly believe this is the first step.”

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