The Next Big Thing in Telehealth: CMS Expansion

Can you imagine your life without the convenience of an Uber ride to the airport, or a last-minute Amazon order when guests are coming in town? With the rise of apps/services like Uber and Amazon, the use of telehealth is gaining popularity with members and health plans alike. Medicare Advantage members are no different. They want easy access to care that meets their standards and needs. Telehealth, meet CMS Expansion.

Medicare Advantage plans will offer government-funded telehealth services to seniors starting in 2020. Previously, telehealth was only covered for those in rural areas. This opens up an accessible and flexible option for members to keep up with their care without having to visit a provider’s office. This change also gives plans greater flexibility to offer clinically-appropriate telehealth benefits not otherwise available to Medicare beneficiaries.

This isn’t just about expanding care access – this is a growing market. One third of medicare beneficiaries chose private insurance (Medicare Advantage vs. just government benefits). Projections show this growing by 11.5% with the entry of the baby boomer generation.

So, why does this matter for health plans?

  • Telehealth services will be reimbursed
  • Cost savings for health plans and members compared to usage of Urgent Care and Emergency Room visits (when used correctly)
  • Better member engagement
  • Improved ratings from positive member experience and satisfaction
  • Differentiate your health plan from all the other choices out there

Imagine receiving a note from your health plan noting the benefits of using a telehealth service for a cold, sore throat, or a minor rash and they tell you it saves them money. Now imagine receiving an email that shows your cost savings as a member by using telehealth services versus going to the ER. One is an okay experience focused on the health plan’s benefit, and the other is an improved, member-focused experience.

How can health plans succeed with telehealth services in CMS expansion?

  • Utilize telehealth as a part an engagement platform
  • Make the experience intuitive (don’t bury the services under multiple clicks, etc.)
  • Promote the telehealth service with a multi-channel technology approach – SMS text message notifications are a great way to notify members

Bottom line. Members want convenience and they’ve come to expect it. The CMS Expansion into Telehealth provides a framework for easy access to quality care. And this flexibility means lower costs and more engaged members.