Although in-person visits will remain the gold standard for quality health-care services, the last year proved that convenient virtual options could support remote workers wherever they live, and give employers additional enticements for attracting and retaining talent.

From June to November 2020, the U.S. Centers for Disease Control found that telehealth sessions accounted for more than 30 percent of visits each week. In addition, a Willis Towers Watson global benefits attitudes survey showed that employees who used virtual care were more likely to say they got the care they needed, compared with those who used in-person care.

“It’s really critical that people get both the mental and physical health care that they need,” said Julie Stone, managing director of health and benefits for the consulting firm, adding that telehealth ensures that care.

“That’s why I think that telehealth has legs,” she noted.

It also will help employers provide quality care services to remote workers, regardless of where they are located, since health care may not be equal in quality or access everywhere, she says.

Older and Black patients particularly satisfied

The global benefits attitudes survey released in November by Willis Towers Watson, which is based in London, also showed that more employees reported that virtual care gave them the help they needed to deal with chronic health conditions and/or anxiety and depression compared with in-person services.

While all age groups ranked their satisfaction higher when they used telehealth services, older workers particularly liked the mental virtual care options. For people in their 40s, 73 percent of the people who chose the virtual option reported that they got the care they needed, compared with just 49 percent of users of in-person services. For those in their 50s, 78 percent favored virtual care versus 29 percent for in-person services.

In addition, Stone notes that telehealth services also may improve healthcare equity for people of color, a current topic of concern for public-health experts. The survey showed that about 57 percent of the Black respondents indicated that by using virtual mental-health services, they felt they were able to get the help they needed. That compares with 27 percent of those who were using in-person care.

Stone notes that another Willis Towers Watson survey found that while almost half of companies with on-site or near-site employee health clinics kept them open during the pandemic, almost 80 percent added or increased the use of virtual care.

“Now we are hearing that [these virtual services] will be sustained, even with hybrid [work location] models,” said Stone, noting that two out of three companies are expected to continue offering such services.

Covid-era policy shift

As the Covid-19 threat spread in early 2020, some state licensing requirements were eased by the federal government to allow telemedicine providers to work across state lines. A CDC report said virtual health services could “facilitate access to care, reduce risk for transmission of SARS-CoV-2, conserve scarce medical supplies and reduce strain on health-care capacity and facilities while supporting continuity of care.”

As a result, the policy shift “literally opened up access in the mental-health [and physical health-care] services,” said Mark Cunningham-Hill, medical director of the Northeast Business Group on Health, a nonprofit group of employers and health-care providers based in New York City. “Before the pandemic, utilization was relatively low.”

Convenience was a big attraction for workers, but employers’ fears that it would be overused — and increase benefit costs — were unfounded. In fact, Cunningham-Hill notes that telehealth can help patients get the care they needed early on before a condition becomes more complicated and costly.

“Maybe we’ll move to a hybrid model going forward where we’ll see people once and make that physical and personal connection, and then we’ll transition to video telehealth,” said Cunningham-Hill, who is based in Paoli, Pa. “It might be a steppingstone to make it more ingrained in how things work.”

Unfortunately, the former state-by-state licensing rules will probably be renewed when the emergency is over, adds Stone, who is based in Morristown, N.J.

“That’s a policy issue that employers are going to need to weigh in on to preserve the improved access,” she said.

‘No barriers to access’

Cunningham-Hill says one of the great advantages of virtual mental-health services provided through healthcare plans or through online care organizations like Ginger and Lyra is that they reduce the stigma that may keep people from seeking the help they need.

“The nice thing is that there are no barriers to access. There is no stigma. You can do it on the phone … and everybody’s on the phone these days,” he said. The virtual services are popular among members of Northeast Business Group because they add another layer above the counseling sessions that employee assistance plans (EAPs) and healthcare-networks provide, he adds.

Companies will have to offer digital tools like intranet sites to show different options and allow people to navigate to find what they need, he says.

“But we’re not there yet,” he warned. Plus, with remote workers moving to other states and even countries, accessing services covered by their employer “does get a little more complicated.”

Stone offered these tips for improving awareness about telehealth options and engagement:

  • Larger employers can track anonymized data on race, ethnicity, gender and other demographics to find out if certain groups are having difficulty accessing the care they need.
  • Periodic “pulse” surveys or virtual focus groups can uncover how well employees feel their needs are met by the benefit-plan offerings.

She also notes that the pandemic raised awareness about the importance of mental-health care and employers should respond accordingly, particularly since younger employees are more open about such topics and want company support.

“We’re not going to go back to the way things were before, two or three years ago, when people were hesitant to talk about” mental health, she said.

For his part, Cunningham-Hill said he hopes the pandemic’s virtual-care learning period was “just enough to nudge … a change in the way we deliver health care that hopefully makes it more efficient going forward.”

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