Telehealth is here to stay, so why won’t employees sign up?

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Employers have welcomed telehealth benefits with open arms, but they’re having a hard time getting employees to share their enthusiasm.

Almost 75% of major employers offered some type of telehealth benefit in 2018, according to the Kaiser Family Foundation Employee Health Benefit Survey, up from just 27% in 2015. That number doesn’t include medium- and small-sized businesses, which also have embraced the benefit.

Telehealth, usually defined as medical care delivered via telephone, visual technology or a combination of the two, can often replace more costly trips to the doctor’s office, urgent care center or emergency room. Employers like it because it can potentially cut healthcare costs and offers a convenient way for employees to get the care they need without long waits and high copays.

Imagine, for example, an employee is on vacation deep in the woods and gets a nasty rash that could be poison ivy. The employee calls their telehealth provider, sends a picture of the rash and is told within minutes what it is, what over-the-counter medicine to treat it with and where the nearest drugstore is located. Vacation is not interrupted, the employee is happy and their employer saves the cost of a miles long trip to the nearest ER or urgent care.

But telehealth doesn’t save employers money if workers don’t use it. The average employee sign-up rate for large employers who offered telehealth services either through their health plan or a specialty vendor was only 8% in 2017, according to the Mercer National Survey of Employer-Sponsored Health Plans. J.D. Power reports only 9.6% of Americans have used telehealth services of all types, including those provided by employers.

“Telemedicine makes so much logical sense,” says Beth Umland, director of research for health and benefits at Mercer. “That’s what’s driving the quick adoption by employers and health plan services. But utilization has been lagging.”

“It’s definitely difficult for employers to break down the barriers and get employees to try telehealth,” says Elie Goodman, vice president of marketing at MeMD, a telehealth provider.

“Our data shows that once employees try telehealth, they’ll use it again. But getting them to take that first step is the challenge.”

Then what is keeping employees from making the call, clicking on the URL or downloading the app? Three things, says Stephany Verstraete, chief marketing officer at Teladoc Health.

“First, many times employees don’t know they have the benefit. Second, employees don’t remember they have the benefit at the moment they need it. Third is the notion of behavior change. Employees are hesitant at first, asking themselves is this quality care?” she says.

All three stumbling blocks can stem from a lack of education and communication on the part of the employer, Verstraete adds.

But some employers are bucking the low utilization trend. The U.S. division of Adecco, for example, the Swiss-based human resources and temporary staffing company, has logged a 44% utilization rate among U.S. staffers since it began providing telehealth benefits about two years ago. The company says it has saved more the $230,000 in total thanks to its telehealth services.

“The fact that Adecco is an HR company and excels in people management probably has something to do with their success,” says Mary Modahl, senior vice president and chief marketing officer at American Well, Adecco’s telehealth provider. More important is the fact that Adecco has executed and continues to execute the full communications program around telehealth, explains Modahl. That includes emails, direct mail, posters, videos, membership cards and ongoing seasonal and news-oriented communications.

“Some HR teams are less confident about doing a full communications program and that can limit their success. Adecco’s team has been very face forward and effective,” Modahl explains.

Employee Benefit News spoke with several leading telehealth providers to find out what other companies with successful telehealth engagement rates are doing. These best practices may offer some ideas for boosting engagement with a telehealth program.

Stress quality and convenience

To allay employees’ concerns always stress the quality of your telehealth offering, clearly communicate the qualifications of doctors and other health professionals employees are likely to encounter.

Telehealth provider Doctor on Demand offers a favorite doctor service. Employees can ask for the same doctor to help feel more confident and comfortable with telehealth visits. “This enables employees to experience a continuum of care,” says Cameron Hume, senior director of account management at Doctor on Demand.

At the same time, play up the convenience factor, the aspect of telehealth that is most appealing to employees. Adecco found the average telehealth visit lasted about 6 minutes compared to a 121-minute visit to the doctor’s office.

The company also used testimonials from top executives who had themselves used the service to get employees to try it. “We had fun with our employees while getting the word out about [American Well],’” says Brian Evans, vice president of human resources for Adecco Group, in a case study published by American Well.

Tailor communications to different demographics

Millennials, who are comfortable with technology and likely don’t have a primary care physician, are high potential targets for telehealth. But don’t overlook the need for these services among employees age 45 to 60, who can be squeezed between the health needs of themselves, their own kids and aging parents, says Modahl. Communications tailored to individual demographic groups can be more effective than one-size-fits-all messages, MeMD’s Goodman says.

Frequent touchpoints also help. Reminders that telehealth is there to help during flu season, natural disasters, measles outbreaks and other events can help drive utilization. One MeMD client encourages managers to remind employees who call in sick that telehealth is available to them, Goodman says.

Use data to help target employees

Teladoc helps clients use claims data and other analytics to identify and reach employees based on their specific care needs, explains Verstraete.

“A first communication may be a welcome kit that goes to everyone but a second communication may be a targeted email or digital outreach via Facebook to employees who may need mental healthcare benefits,” she says.

Keep copays low

Some employees hesitate to use telehealth because they figure the telehealth provider will just tell them to see their doctor, meaning they end up paying two copays instead of one. In some cases this does happen but not always. Keeping copays low can help minimize this complaint when it does.

“Among midsize employers we’re seeing that once an employer makes telehealth available for free, utilization rates can rise 40%,” says Modahl. Employer cost-savings is significant enough to make the zero copay worth it, she adds.

Put telehealth in the employee’s pocket or wallet, key chain or phone

Make sure employees have easy access to the telephone number, URL and smart phone app. It sounds basic, says Verstraete, “but if it’s not right in front of them, they won’t do it.” Providers have discovered a number of successful ways to do this, including key chain cards, text messages with links, phone numbers and wallet cards.

Incentives also help. Adecco offered gift cards to all employees who signed up for the app. Wellness dollars and healthcare cost discounts are also popular.

Telehealth is pervasive and growing all the time, says Umland. “Now employers just need to convince employees how great it is,” she adds.

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