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National Business Group Survey: Telehealth on the Rise, Uncertainty around ACOs

August 12, 2016
by Rajiv Leventhal
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Nine in 10 employers will make telehealth services available to employees in states where it is allowed next year—a sharp increase from 70 percent this year, and from 7 percent in 2012, according to a recent National Business Group on Health survey.

By 2020, virtually all large employer respondents will offer telemedicine. Utilization by employees remains low, but is increasing steadily, according to the “Large Employers' 2017 Health Plan Design Survey,” of 133 large employers conducted between May and June 2016.

Much of this growth is driven by health plans including telehealth as a part of their services, but 31 percent of large employers are direct contracting with telehealth vendors. Utilization rates in 2015 averaged 1 percent of eligible employees. In the first half of 2016, 3 percent of employees have already utilized the benefit, the data revealed.

The same survey also revealed some findings about accountable care organizations (ACOs). At this point, many employers are hesitant to devote too many resources to promote ACOs within their workforce. Roughly a quarter (24 percent) will be actively promoting ACOs in 2017, according to the report. But, 65 percent of respondents said that while some of their plans may include ACOs, they aren’t looking for or promoting them.

What’s more, approximately half of employers are unclear what impact ACOs will have on healthcare costs, but many other employers have high hopes for ACOs in the future. When their plans are composed of networks of ACOs that are still mostly in the launching phase, many employers expect the impact on trend to be relatively small. As the ACOs in the plan develop, most employers expect a moderate impact on medical trend.

The expectations for high-performance ACOs are more varied—given that there aren’t many around yet to help set expectations—but some employers expect the percentage point reduction in trend could be quite significant. A five percentage point reduction in trend could lead to a year or two of flat trend, based on current projections for trend, according to the report.

When asked about high performance ACOs in more detail, many employers are unclear about what costs to expect from ACOs compared to what is available in the market today. Among employers with an estimate, most employers believe that a high-performing ACO might come in at 3 percent to 5 percent more below market cost.

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