The Number: 83

Submitted by Rob Wyse on Tue, 08/14/2018 - 10:45
Medicare Advantage members unsure if telehealth is offered by plan

This July, the Centers for Medicare & Medicaid Services (CMS) proposed the 2019 Medicare Physician Fee Schedule and Quality Payment Program, which includes expanding Medicare-covered telehealth services to include prolonged preventive services. 

While coverage of telehealth services is expanding, it appears that 83 percent of Medicare Advantage members either do not know if they can connect via their plan to telehealth providers, or do not think telehealth is offered at all through their plan. Our June/July 2018 HealthMine survey found 46 percent of Medicare members were unsure if their plan offers telehealth, while 37 percent said it is not offered.

Plus, the respondents were computer literate, as the survey was fielded online. And they are connected: 77 percent of respondents use a smart device (a smartphone or tablet). 

The challenge for Medicare Advantage plans is to educate members on how, when and where to use telehealth. A $40-$50 telehealth visit, versus an in-person visit for a routine procedure, could mean millions in savings for a plan. And, it will add up to billions in savings for overall Medicare.

According to a CMS press release issued on July 12, 2018 announcing the proposed program, CMS Administrator Seema Verma said, "CMS is committed to modernizing the Medicare program by leveraging technologies, such as audio/video applications or patient-facing health portals, that will help beneficiaries access high-quality services in a convenient manner."

A key to getting members to connect is for plans to truly understand communication preferences.  Our data shows that plan members have a growing preference for digital communication.  Thirty-four (34) percent of members are using digital communication with the plan, while 47 percent would prefer digital communication.

Plans can seize the moment with this unprecedented an opportunity of a perfect telehealth storm. 

First, awareness of telehealth will only grow with better diagnostics.  Second, there are 10,000 baby boomers per day becoming Medicare eligible, which means that we will have more beneficiaries who are technologically proficient.  And, finally, CMS is taking steps to expand Medicare-covered telehealth services to include prolonged preventive services.