Employers and payers encourage employees to think beyond the hospital, clinic when considering low-cost sites of care

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Ingrid Stiver Senior Manager, Health Research Institute, PwC US February 04, 2020

In 2020, employers will strive to find the right mix of virtual and in-person benefit offerings and expand the scope of telehealth offerings.

Employers continue to emphasize telehealth and make it an attractive care option for employees. In 2016, 41% of employers offered the benefit; in 2019, 86% did. Plus, 61% of employers set employee cost sharing lower for telemedicine visits than in-person visits in 2019. 

Many employers and payers have added telehealth as an option for urgent care. But according to the 49% of consumers HRI surveyed with employer coverage willing to use telehealth, the most popular perceived use was ongoing treatment of a physical condition or ailment. 

Some employers already are responding by expanding telehealth offerings to target specific conditions, including chronic back pain. An estimated 1.4 million individuals with employer-based insurance suffered from musculoskeletal issues in 2015 to the tune of approximately $2.5 billion. In partnerships with employers, one telehealth company delivers a 12-week virtual physical therapy program to employees with chronic back or joint pain, focusing on sensor-guided exercise therapy.

The program provides patients with self-management tools that help them avoid prescription drugs or surgery and eliminates some of the barriers to in-person physical therapy, such as time constraints for appointments, costs of transportation and challenges to tracking outcomes and program adherence.

According to a study conducted by Cleveland Clinic researchers of another digital platform for physical therapy, patients’ adherence to digital at-home therapy was almost 80 percent, compared with 35 percent to 70 percent for traditional physical therapy.

Employers and payers also are nudging employees to receive administered drugs in lower-cost ways, including in their homes. According to the Health Care Cost Institute, employer spending on administered drugs, such as those that must be infused or injected intravenously, increased 45% from 2013 to 2017. The cost of infusion and intravenous medications in the home setting is lower than in a medical office or hospital outpatient center. There is an overwhelming opportunity to realize savings—for example, only 4% of patients receive the infusible biologic Remicade, a drug that treats arthritis and certain bowel and skin diseases, in the home setting. Patients also tend to prefer home infusion therapy.

For citations, implications and insights, please read our full report, Medical cost trend: Behind the numbers 2020.

For more of HRI’s insights and content, visit our Regulatory Center and report library.

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Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

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