When Nurse Support Makes All the Difference: One Family’s Story

nurse support

The Vincent White Family

Facing a Difficult Surgery

Vincent White tried everything to get rid of his back pain. Neck clamps. Surgery. Spinal decompression. This lab supervisor at Carolinas Healthcare had persistent pain from a narrowed bone channel housing the spinal cord and nerves.

The calcification worsened. Finally, doctors recommended another back surgery. “He was stumbling around the house,” said wife Lisa. “He could barely move.”

When Lisa walked into her husband’s hospital room after the operation, a doctor from the critical ICU team delivered bad news. Vincent was paralyzed.

“He was in ICU for 21 days,” said Lisa. “Doctors said he probably would not walk again.” Vincent had another surgery while in ICU to repair a spinal cord leak. After six weeks in rehab, he came home to his wife and 11-year-old daughter Olivia.

Experienced Nurse Support
Stepped In

Long before Vincent’s release, Lindsay Spainhour, RN, BSN, the Whites’ MedCost Case Manager*, was working with the medical providers, planners and discharge team. Lindsay followed his progress closely to ensure that he received all the care needed in this crucial time of their lives.

“Lindsay got to know me and took time to care about what my husband and I were going through,” Lisa said. “She got the special kind of air mattress we needed, and told us not to worry about authorization.” nurse supportLindsay called the supplier for Vincent’s wheelchair until it finally arrived. And when Vincent was diagnosed with a wound two weeks after arriving home, she provided education, supplies and questions for Lisa to ask medical staff when Vincent was readmitted to the hospital.

Vincent and Lisa continue to make lifestyle adjustments. He wears a catheter. He can’t take a normal vacation with his family. But Lisa says that their MedCost Case Manager made a big difference.

More Than Just a Job

“She did things she didn’t have to do, to make sure my husband’s needs were met over and beyond. I could tell in Lindsay’s voice that it was more than just a job.

“We sometimes complain about what we pay for premiums, but the benefits of having a case manager like Lindsay far outweighed the cost. Get a case worker. It can save you energy to focus on your family.MedCost


*The Whites gave MedCost permission to share their story to help others realize the benefits of the Complex Case Management program. MedCost Complex Case Management is a program where registered nurses who are also certified case managers work with individuals who have experienced a life-changing illness or injury. The goal of the program is to ensure the best use of available health plan resources while enhancing quality of life.

 

7 Care Management Results: Balancing Medical Care, Benefit Costs

How Can Employers Balance Medical Care & Benefit Costs?

MedCost Care Management programs are designed to conserve health care costs for our clients while improving an individual’s health.

Our nursing staff averages 22 years of experience; and includes board-certified case managers and nurses certified in intrinsic coaching and grief counseling.

Here are our 2017 results that exceed industry averages, resulting in lower health care costs for our clients.

Care Management

Care Management Resources

Want to know more about how to manage medical costs? These resources give employers more details:

  1. Complex Case Management 
  2. Inpatient Management
  3. Outpatient Management
  4. Telehealth Services
  5. Nurse Health Coaching
  6. Maternity Management
  7. Behavioral Health

To print this infographic, click on the title and scroll to “PRINT THIS PAGE” at the bottom.MedCost

HSA 2018 Contribution Limits Adjusted by IRS

Michael Berwanger

By Michael Berwanger, JD, Director, Quality Management & Compliance

On March 5, 2018, as a result of the tax reform law (P.L. 115-97), the IRS released Bulletin No. 2018-10, adjusting dollar limitations for health savings accounts (HSAs) and high-deductible health plans (HDHPs) for 2018.

The only change impacting HSAs was to adjust the contribution limits for family coverage from $6,900 to $6,850.

HSA 2018 Contribution Limits

HSA 2018 Contribution Limits: FAQs

For guidance on HSAs, please review the IRS frequently asked questions pageMedCost

This blog post should not be considered as legal advice.

 

Helping Employers Achieve the Benefits Balance

Employers Benefits Balance

CLICK IMAGE TO WATCH VIDEO

Balance.

An even distribution of weight enabling someone or something to remain upright and steady.

A condition in which different elements are equal or in the correct proportions.

The definitions make it sound easy—spreading the load around so no one person or group is under duress.

But balance is quite elusive.

We strive for it in all aspects of our lives.

Employers are no exception.

Employers Benefits BalanceThey struggle with it in the workplace, especially as it pertains to benefits.

CEOs, CFOs and HR directors are caught in the tugs of emotion and cost spreadsheets.

MedCost helps employers in their pursuit of balance.

Balancing medical care and cost management. Balancing the ideal with the reality.

Other benefits administrators can’t match our integrated clinical programs that combine member care with effective claims management.

And big name insurance companies, well, they use a scale. Scales are not negotiable. They don’t allow employers to make choices.

Achieving Employers Benefits Balance

MedCost helps self-funded companies balance self-care, the health of their company, with the care of others, their employees.

We enable companies to achieve the benefits balance™ that’s right for them.

MedCost. That balance is built right into our name.MedCost

(This is a transcript of the video, “Helping Employers Achieve the Benefits Balance.”)

Employers Benefits Balance

CLICK IMAGE TO WATCH VIDEO

*More Information for VA Employers
*More Information for NC Employers
*More Information for SC Employers

 

How to Help Employees Become HEALTHY & WHOLE (Video)

Ready to Balance the Care of Your Employees
with the Financial Health of Your Company?
HEALTHY & WHOLE

WATCH VIDEO NOW

  • Annual health care costs in America are $3.2 trillion.
  • Employers average 5.3 unplanned sick days per year.
  • That productivity lost is more than 1 and 1/2 hours of an 8-hour day.

When disease management and wellness programs combine, employers average $30 per member per month in decreased health care costs.

HEALTHY & WHOLE

That’s why we’ve developed a comprehensive program called HEALTHY & WHOLE.

HEALTHY & WHOLE encompasses physical, emotional, financial and social health – and
greater job satisfaction for employees.

The goal is to help employers balance the care of employees with the financial health of your
company.

HEALTHY & WHOLE Includes Disease Management

Our nurse health coaches provide hands-on support, helping members reduce blood
pressure, glucose levels and lose weight.

And for complex conditions, case managers provide expert help for families in very difficult
situations.

Over 73% of businesses offer corporate wellness to attract and retain talent, and strengthen
company culture. Another advantage is to encourage enrollment in consumer-directed health
plans, a growing trend.

HEALTHY & WHOLE Supports Lifestyle Changes

HEALTHY & WHOLE addresses not only members with chronic diseases, but the 75% who
need support with lifestyle changes.

Lifestyle changes – even small ones – create measurable outcomes of better health, productivity and bottom line.

The Results of Corporate Wellness Programs

HEALTHY & WHOLE

http://www.nahueducationfoundation.org/materials/WellnessBrochure.pdf

Implementing corporate wellness programs dropped claims costs -28%, doctor visits -17% and hospital admissions -63%.

This same study showed disability costs down -34% and injury incidence down -25%.

An employer we worked with said that he is passionate about having happy employees. If they
are happy, they will be productive and engaged.

A Program That Benefits Employees and Companies

Lifestyle coaching. Financial education. Fitness. Nurse health coaching. Long-term medical
conditions. HEALTHY & WHOLE serves everyone’s needs, including your company’s.

We want to see everyone HEALTHY & WHOLE. That’s why it’s important to us to balance the care of your employees with the financial health of your company.MedCost

HEALTHY & WHOLE

PLAY VIDEO

(This post is a transcript from the video, “MedCost HEALTHY & WHOLE.”)

For more information on wellness consultations for employers, email Kati Davis.

 

FDA Approved 46 Novel Drugs in 2017

MedCost pharmacist

By Zafeira Sarrimanolis, PharmD, MedCost Clinical Consultant

In 2016 we saw 22 brand-new novel drugs hit the market. This year the FDA has approved 46 novel drugs.

A novel drug is an innovative product with a chemical structure that has never been FDA approved before and usually meets a previously unmet medical need.

In 2017, these novel drug approvals were accompanied by an influx of specialty and brand-name drugs to the market – many treating common chronic conditions like diabetes, asthma and RA.

It is a very exciting time in the healthcare world as these new drugs significantly advance patient care. However, these treatments come at a cost… literally.

This is not a comprehensive list of new-to-market drugs, and does not include all 46 novel drugs, but is a snapshot of key 2017 FDA approvals.

It is hard to predict what the FDA and drug manufacturers will do in 2018. However, we should expect even more high-cost drugs to be approved and available for members.

Hopefully these will be accompanied by the influx of generics and biosimilars to the market – which may help off-set rising drug costs.

One thing we know for sure is that managing drug costs will continue to be key. We employ cost-management strategies such as:

  • Formulary management
  • Prior authorizations
  • Step-therapy programs
  • Regulation of copay cards

All of these strategies will be foundational in conserving costs.MedCost

Drug
Approval Date
Approved Use(s)
Estimated Annual Cost
Notes
Hemlibra

(emicizumab)

11/16/17 Hemophilia A with FVIII inhibitors $450,000
Mepsevii

(vestronidase alfa-vjbk)

11/15/17 Mucopolysaccharidosis VII (MPS VII, Sly syndrome) $375,000
Fasenra

(benralizumab)

11/14/17 Severe asthma (add-on treatment) $30,000
Yescarta

(axicabtagene ciloleucel)

10/18/17 B-cell lymphoma $370,000
Verzenio

(abemaciclib)

9/28/17 Breast cancer $130,000
Aliqopa

(copanlisib)

9/14/17 Relapsed follicular lymphoma $160,000
Kymriah

(tisagenlecleucel)

8/30/17 Acute lymphocytic leukemia $475,000 per treatment First gene therapy ever approved in the US
Bespona

(inotuzumab ozogamicin)

8/17/17 Relapsed or refractory acute lymphoblastic leukemia $170,000

 

Idhifa

(enasidenib)

8/1/17 Relapsed or refractory acute myeloid leukemia $280,000

 

Vosevi

(sofosbuvir, velpatasvir, voxilaprevir)

7/18/17 Hepatitis C $75,000 for 3-month treatment
Nerlynx

(neratinib maleate)

7/17/17 Reduce risk of breast cancer returning $125,000
Tremfya

(guselkumab)

7/13/17 Moderate-to-severe plaque psoriasis

 

$58,000
Endari

(L-gultamine)

7/7/17 Sickle cell disease $11,000 – $18,000 Second drug approved for Sickle Cell in the US
Haegarda

(C1 esterase inhibitor)

6/22/17 Hereditary angioedema $400,000
Fibryna

(fibrinogen)

6/7/17 Congenital fibrinogen deficiency n/a Pending launch date
Rebinyn

(coagulation factor IX)

5/31/17 Hemophilia B n/a Expected launch early 2018
Kevzara

(sarilumab)

5/22/17 Rheumatoid arthritis $39,000 Second-line agent
Radicava

(edaravone)

5/5/17 ALS $145,000 Second drug ever approved for ALS
Ryadapt

(midostaurin)

4/28/17 Acute myeloid leukemia $180,000
Brineura

(cerliponase alfa)

4/27/17 Batten disease

 

$700,000 Very rare, inherited condition
Ingrezza

(valbenazine)

4/11/17 Tardive dyskinesia $64,000 – $128,000 depending on dose
Ocrevus

(ocrelizumab)

3/28/17 Multiple sclerosis $65,000 (~20% less than current treatments)
Dupixent

(dupilumab)

3/28/17 Moderate-to-severe eczema $37,000
Zejula

(niraparid)

3/27/17 Epithelial ovarian, fallopian tube or primary peritoneal cancers $160,000
Bavencio

(avelumab)

3/23/17 Merkel cell carcinoma $150,000
Kisqali

(ribociclib)

3/13/17 Breast cancer $130,000

 

 


Key sources:

 

(To print, click on the title and scroll to “PRINT THIS PAGE” at the bottom)

 

IRS Extends Deadline to Furnish 1095 Forms to Individuals

Michael BerwangerBy Michael Berwanger, JD, Director, Quality Management & Compliance

The IRS has announced good-faith transition relief for information reporting on Forms 1094 and 1095 for the 2017 tax year, mirroring guidance it provided for the 2016 tax year (see IRS Notice 2018-06 HERE).

Some notable highlights include:

Extension for Furnishing Statements to Individuals. 

The deadline for furnishing Forms 1095-B and 1095-C to individuals is extended by 30 days, from January 31 to March 2, 2018. There is no action necessary from self-funded health plans to take advantage of this extension, it is automatic.

Due to this extension, the discretionary 30-day extension is not available, and no further extensions may be obtained by application to the IRS.

No Extension for Filing Returns with the IRS.

The notice does not extend the due date for filing Forms 1094-B and 1094-C (and accompanying Forms 1095) with the IRS. Accordingly, the deadline remains February 28, 2018, for paper filings, and April 2, 2018, for electronic filings (see 2017 Forms 1094, 1095 B & C Released by IRS).

Please note, electronic filing is mandatory for entities required to file 250 or more Forms 1095. However, filers may obtain an automatic 30-day extension by filing Form 8809 on or before the regular due date.

2017 Forms 1094 1095Good Faith Penalty Relief.

The IRS will again provide penalty relief for entities that can show they have made good faith efforts at compliance.

The IRS reports that no penalties will be imposed on entities that report incorrect or incomplete information, either on statements furnished to individuals or returns filed with the IRS, if they can show they made good faith efforts to comply with the reporting requirements.

The notice specifies that the relief applies to missing and inaccurate taxpayer identification numbers and dates of birth, as well as other required information.

Penalty relief is not available to entities that fail to furnish statements or file returns, miss an applicable deadline, or are otherwise not making good faith efforts to comply.

Evidence of good faith efforts may include gathering necessary data and transmitting it to a third-party to prepare the required reports, testing the ability to transmit data to the IRS, and taking steps to ensure compliance for the 2018 tax year.

ACA deadlinesThose unable to meet the due dates are still encouraged to furnish and file as soon as possible, as the IRS says it will take such furnishing and filing into consideration when determining whether to abate penalties for reasonable cause.

Reasonable cause is distinct from good faith relief and requires, among other things, proof of significant mitigating factors or events beyond the reporting entity’s control.MedCost


MedCost is not a tax preparation company, and you may have additional tax obligations for other benefit plans that you offer to your employees. Please consult with your tax adviser for guidance.

This blog post should not be considered as legal advice.

GIVING BACK: 3 Reasons for Corporate Philanthropy

When Corporate Giving Becomes Personal
Giving Back

2017 Winston-Salem Heart & Stroke Walk (Photo by Patrick K. Smith)

By Debbie Pullen, Content Marketing Specialist

This year I had the privilege of participating in my company’s annual corporate sponsorship for the American Heart Association.

Our leadership felt passionate about supporting the annual Winston-Salem Heart & Stroke Walk, because of how local medical research is funded through national and area fundraising. Our nurses and support staff work daily with members recovering from heart attacks, strokes and other complex conditions.*

So we really had a “heart” for this issue.

The big surprise for me was how much my involvement would come to mean to me personally.

I discovered three wonderful reasons why companies give.

#1 REASON FOR GIVING BACK

Giving Back Aligns Company Actions with Company Values
Giving Back

Michelle at Soup Cook-Off

Our commitment to be major sponsors for the Heart & Stroke Walk originated with our executive leadership. They wanted every employee to have the chance to support company fundraisers and to walk the 1-, 2- or 4-mile route on November 11, 2017.

Fundraisers such as our Soup Cook-Off, Executive Embarrassment Challenge** and Basket Raffles progressively built excitement in the months leading up to the walk. Employees from every department signed posters, took photos shared on social media and contributed to our company total.

A spirit of anticipation grew as people talked in the break rooms about family or friends who had suffered heart disease or strokes. Employees shared their own stories about recovering from serious medical conditions (see “Heart Disease: Living Up to the Gift of Life“).

The MedCost principle of getting healthy and staying healthy was underscored over and over with social shares like this infographic from the Triad AHA.

Giving Back

American Heart Association

Facts such as “Heart disease is the #1 cause of death in the United States” were sobering. Even more sobering was this one:

80% of deaths from coronary artery disease are PREVENTABLE, due to obesity, lack of physical activity, heavy drinking, unhealthy diets and other factors.

Centers for Disease Control and Prevention

.

Our company found perfect symmetry with the American Heart Association’s missionto build healthier lives, free of heart diseases and stroke. As the saying goes, we put our money where our mouth is.

Beginning in 2016, MedCost became a major sponsor of Triad AHA’s annual Heart and Stroke Walk.

#2 REASON FOR GIVING BACK

Giving Back Defines What Community Is
Giving Back

(L-R, Sarah Fedele, Heath Combs, Kati Tsiolkas, Taylor Logeman, Kaitlin Hemric, Debbie Pullen at Wake Forest Innovation Quarter)

 

 

 

 

 

 

 

 

 

I collaborated with Sarah Fedele, Triad AHA Director of Communications and Marketing, to lead a monthly group of social media colleagues. We brainstormed promotions and event activities, while getting to know each other better.

Our group represented over 100 companies sponsoring the annual walk. These talented professionals from banking, health care, medical device manufacturing and other industries contributed a larger vision for corporate giving.

“AHA Heart and Stroke Walk is something very near and dear to us as a company. Working together with other local companies really defines what community is all about.”

  • Kati Tsiolkas, Brand Marketing Specialist, Endoscopy
    Cook Medical
Giving Back

(L-R, Sarah Diamont, Debbie Pullen, Edee Wilcox, Sarah Fedele, Kati Tsiolkas, Taylor Logeman)

Edee Wilcox, another key member of the social media team, said that working together for a common cause developed our understanding of community.

“Getting to know other social media admins in the area and supporting each other has helped increase appreciation for what we do collectively and individually in our community.”

We were seeing that all of us together could build a healthier community.

#3 REASON FOR GIVING BACK

Giving Back Benefits Our Health, Too

Something happened to me as I worked on promotions with our internal teams and sponsors from other industries in our area. The Heart and Stroke Walk became more than just a social responsibility.

It became more than a PR effort that would position MedCost’s reputation favorably.

The numbers began to talk to me.

Giving Back

  • About 60% of stroke deaths occur in females
  • 80% of strokes CAN BE PREVENTED.
  • Lowering your top number (systolic) by 20 mm Hg and your diastolic blood pressure by 10 mm Hg may decrease your risk of stroke and ischemic heart disease by about 50%.

I began to focus on improving my own health, along with conducting a successful charitable campaign.

I knew that MedCost helps employers avoid many unnecessary health costs through wise benefits administration. I knew that preserving employee health through regular screenings and annual physicals would keep medical conditions from escalating.

Giving BackBut I didn’t know how 100 companies working together could achieve AHA grants for $1.2 million for local heart and stroke research in our local medical schools and universities in 2016.

Sarah and Kelly in our social media group expressed it well.

“We are helping people to be aware of the warning signs of heart disease and stroke and  to make healthy lifestyle changes to prevent heart disease and stroke. We are building a true culture of health in Winston-Salem, Forsyth County and across North Carolina.”

Giving Back

Over 5,000 brave the cold for 2017 Winston-Salem Heart & Stroke Walk

 “Together we are so much more powerful and effective than we could ever be apart.”  – Kelly Minor, Marketing Communication Specialist at Piedmont Federal Savings Bank

Is it really more blessed to give than to receive?

Something happens when we think of others first. Extend our gifts, our time. A little bit of ourselves.

I’m thinking of my social media friends, who labored on behalf of their companies to raise much-needed funds for local and national research.

I’m thinking of heart and stroke victims affected by these top killers in America.

I’m thinking of 5,000 walkers who got out of bed on a freezing November morning to come downtown and bring hope for our community.

Giving back. Isn’t this the best way to celebrate the life we’ve been given? MedCost


*MedCost, which administers self-funded health plans for employers in NC, SC and VA, has long embraced a culture of generosity, both to employees and as a corporate citizen.

Giving Back

Greg Bray, MedCost CFO with Allison Brashear, MD, Walk Co-Chairs

**Employees donated to the manager they wanted to see wear an embarrassing costume on the day of the walk. Michael Berwanger (below) was one of the “winners.”

Giving Back

(L-R, Michael Berwanger, Greg Bray)

10 Terms You Need to Know in Self-Insured Health Plans

Confused by all the “insurance-speak” in your company health plan? Here’s a quick guide for phrases in benefit plans for self-insured employers.


self-insured

WATCH VIDEO HERE

Self-Insured: What Does It Mean?

1 Self-Insured: Also called self-funding. Employers choose this model of funding to pay for health claims from company assets and employee premiums. Self-insurance allows employers to pay only for actual claims, instead of the fixed premiums of fully-insured plans. A 2013 study by the Kaiser Family Foundation noted three of five covered employees are in self-insured health plans.[1]

2 ERISA: Employee Retirement Income Security Act of 1974, passed by Congress to establish federal regulations for self-funded benefit plans. Self-funded employers avoid fees such as the Health Insurance Provider Fee,[2] Risk Adjustment Fee[3] and Federally Facilitated Exchange User FeeSelf-funded employers also avoid certain state premium taxes.

3 SPD: Summary Plan Description that lists health plan terms and conditions, written for a particular employer or organization. The SPD defines the benefit coverage and exclusions. MedCost ensures that coverage and exclusions mirror the stop loss contract. If the stop loss contract does not mirror benefits offered, the employer may have to pay claims that were not covered by the stop loss carrier.

Fixed Vs. Variable Cost

self-insured

4 Fixed Cost: Predetermined fees that are paid as part of a health plan, regardless of actual expenses. Fully-insured plans are 100% fixed cost, paid out in set premium rates to the carrier. Self-insured fixed costs range from 18%—21% of total plan costs for administrative fees and stop loss insurance.

5 Variable Cost: Also called soft dollars, which may translate into potential savings for a self-funded employer. Prudent employers deposit funds for the total estimated employee claims into a reserve account in the company’s name. These dedicated funds remain in the employer’s account for future medical expenses if not spent during a plan year. MedCost provides professional underwriting services to help employers ensure that they are adequately covered for both expected and unexpected claims.

6 Corridor: Also known as claims or risk corridor, or margin. Underwriters include this as a cushion to cover unexpected claims. Generally this amount is around 25% for self-funded plans and 20% for fully-insured plans. Expected claims plus risk corridor (for variable expenses) determine the maximum liability (or attachment point).

Stop Loss Insurance

7 Stop Loss Insurance: Coverage designed to protect self-funded employers from the risk of catastrophic claims beyond a predetermined liability. MedCost underwriters recommend policies with consistency between the stop loss policy and the employer’s SPD, to avoid any gaps in coverage when claims are submitted.[4]

8 Specific Stop Loss Deductible: The limit of liability under stop loss coverage on an individual employee covered under an employer’s heath care plan. The employer chooses this amount based on total group size and selected risk tolerance.

Stop Loss Coverage Specific Example

Self-insured
Jane Smith suffers from renal failure and undergoes kidney dialysis. Her claims total $300,000. Jane’s employer is self-funded and has purchased specific stop loss with a $75,000 deductible.

Total Claim $300,000
Employer Deductible $75,000
Amount Reimbursed by Stop Loss Carrier $225,000

9 Aggregate Stop Loss Deductible: This amount is the self-funded employer’s overall or group liability under a stop loss policy. Underwriters typically project expected claims plus a 25% margin to determine an employer’s maximum liability (or attachment point).

Stop Loss Coverage Aggregate Example

self-insured

  • Includes claims paid that do not exceed the specific deductible
  • When underwritten appropriately, expenses should approach the amount of expected claims ($4 million), rather than the maximum liability ($5 million)
Expected claims $4,000,000
25% Margin $1,000,000
Maximum Claims Liability $5,000,000

10 Benefits Administrator: Also called a third party administrator (TPA) or administrative services organization (ASO). Employers typically contract with an administrator to handle benefits plan documents, claims payments and provide other services. Experienced administrative companies like MedCost can preserve significant savings for employers through careful management of resources, with customized benefits and targeted products to meet employer needs.

We’ve spent over 30 years in the industry. We know health care choices are complicated and not getting any simpler.

Questions?

Have questions? Contact your health care consultant or Jason at MedCost for more resources.


 

[1] “2013 Employer Health Benefits Survey,” Kaiser Family Foundation, August 20, 2013, http://kff.org/report-section/ehbs-2013-section-10/

[2] “Affordable Care Act Provision 9010, Health Insurance Providers Fee,” http://www.irs.gov/Businesses/Corporations/Affordable-Care-Act-Provision-9010

[3] “Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors,” Kaiser Family Foundation, January 22, 2014, http://kff.org/health-reform/issue-brief/explaining-health-care-reform-risk-adjustment-reinsurance-and-risk-corridors/

[4] For more information, download Stop Loss Coverage White Paper: Maximizing Benefits, Limiting Risk

Telemedicine: Yes, There’s a Doctor in the House

telehealth A sick child might have a fever at 3:00 am. Or the family might be visiting grandparents a long way from home. But if an employer-sponsored health plan includes telemedicine services, a board-certified doctor’s consultation is only a phone call away.

Employers Are Choosing Telemedicine

An overwhelming 96% of US employers plan to offer telemedicine services in applicable states* in 2018, the National Business Group on Health reports. The reasons for this rapidly growing health benefit are obvious:

  1. Quick ResponseTeladoc, the nation’s largest provider of telemedicine consultations, averages 22 minutes for a call-back from a licensed, board-certified doctor who practices in the caller’s state.
  2. Convenience. This consultation can be held by phone or online. Teladoc requests some medical information before having the doctor return the call.
  3. Appropriate Care for Less. Almost 80% of adult Emergency Room visits are due to lack of access to other providers.** Access to telemedicine visits can limit hours spent away from work, as well as more expensive care at any hour, day or night.

Telemedicine Offers Treatment Alternatives

Telemedicine consultations are not meant to replace primary care providers. But if an employee has one of the minor ailments listed below, 24/7 access is convenient, and reduces spiraling costs for the employer and the employee.

Treatment Alternatives to the Emergency Room

Telemedicine

Common conditions treated through a telemedicine phone call or online visit are:

  • Infections
  • Allergies
  • Pain
  • Minor joint trauma
  • Gastroenteritis (stomach flu)

Telemedicine Services Are Expanding

Teladoc has expanded optional services for employer health plans to include behavioral health. If an employer chooses to add this option, experienced psychiatrists, therapists and counselors would be available at a flat, per-encounter fee. Members can choose to see the same provider throughout the course of care.

Behavioral health conditions*** range from:

  • Stress/anxiety
  • Depression
  • Addiction
  • Domestic abuse
  • Grief counseling

Just a Phone Call Away

Need a better prescription for your health care expenses? Expert care from area doctors may be available with a phone call, whether on vacation at Disney World or in pajamas at 3:00 a.m.

With telemedicine services, there is a doctor in the house.MedCost

______________________________________________________________________________

*Teladoc operates subject to state regulation and may not be available in certain states.

**“Emergency Room Use Among Adults Aged 18-64: Early Release of Estimates from the National Health Interview Survey, January-June 2011.” National Center for Health Statistics. May 2012. https://www.cdc.gov/nchs/nhis/releases.htm (accessed October 31, 2017).

***Consult your employer’s summary plan description for complete coverage details.