Health Strategy Institute (HSI)
knowledge portal unit
knowledge portal unit
research and strategy institute for
in-person health strategy and
digital health strategy
Joaquim Cardoso MSc
Chief Research and Editor
of the Health Strategy Institute — Knowledge Portal;
Chief Strategy Officer (CSO)
of the Health Strategy Institute — Consulting Unit
Senior Advisor — for Boards and C-Level
June 30, 2023
ONE PAGE SUMMARY
UnitedHealthcare has invested $5 billion in data and technology for virtual healthcare.
- Eligible members enrolled in applicable fully insured employer-sponsored plans will have $0 out-of-pocket expense for virtual visits.
- The enhancement will eventually apply to over five million members, eliminating out-of-pocket expenses for virtual visits until at least the end of plan year 2024.
The coverage enhancement aims to make remote urgent care more affordable and convenient.
UnitedHealthcare’s investment in data, technology, research, and innovation supports their broader effort to provide quality care at a lower cost.
Virtual visits can treat a wide range of conditions, offering a more convenient and affordable alternative, particularly outside regular primary care hours.
- Members can connect to care providers through video, phone, or the UnitedHealthcare app, including national providers such as Optum Virtual Care.
DEEP DIVE
UnitedHealthcare invests $5 billion in data and technology for virtual healthcare
Healthcare Finance
Susan Morse
Starting July 1, eligible UHC members enrolled in fully insured medical plans will pay nothing out-of-pocket for virtual visits.
UnitedHealthcare has adopted a $0 out-of-pocket expense benefit for virtual visits for eligible members enrolled in applicable fully insured employer-sponsored plans.
The new coverage enhancement is designed to make remote urgent care more affordable and convenient, UHC said.
Starting July 1, eligible UnitedHealthcare members enrolled in fully insured medical plans, including policies with high deductibles, will begin to pay nothing out-of-pocket for round-the-clock virtual visits, effectively waiving any deductibles or copays, UHC said.
This applies to employer-sponsored plans upon renewal and for newly effective policies. There’s also an option for employers with self-funded plans to adopt a similar policy for their employees.
The coverage enhancement is part of UnitedHealthcare’s broader effort to help people to use technology to access quality care at a lower cost, bolstered by an annual enterprise-wide investment of over $5 billion in data, technology, research and innovation.
WHY THIS MATTERS
By the end of next year, the enhancement will apply to more than five million members, eliminating out-of-pocket expenses for virtual visits through UnitedHealthcare’s designated national virtual care providers until at least the end of plan year 2024, as allowed by current federal regulations.
The Consolidated Appropriations Act, 2023 extended many telehealth flexibilities put in place under the public health emergency, through December 31, 2024.
Eliminating out-of-pocket expenses for virtual care can help improve health equity by reducing the burden of medical costs for consumers and encourage earlier interventions, which can reduce the risk of complications, avoid visits to costlier settings such as the emergency room and make care more accessible and convenient, UHC said.
Virtual visits may treat many of the same conditions as an ER or urgent care, offering a more convenient and affordable alternative particularly at night or on weekends, when many primary care providers are usually unavailable, UHC said. The virtual visits can also help treat a range of medical issues from flu and pink eye to migraines and other concerns, and the physicians may prescribe medication as needed.
Members can connect on demand to a care provider by video or phone or the UnitedHealthcare app, including national care providers such as Optum Virtual Care.
The coverage policy may not be available in all states and is subject to regulatory approval.
THE LARGER TREND
The use of virtual care and telehealth took off during the COVID-19 pandemic, when the federal government relaxed restrictions on its use, and importantly, reimbursed providers for the service at higher facility rates.
The Centers for Medicare and Medicaid Services had extended the use and payment for telehealth to 151 days after the end of the public health emergency, which was May 11. But the 2023 Physician Fee Schedule Final Rule extended payment parity through the end of 2023.
Originally published at https://www.healthcarefinancenews.com.
