More employers are offering telemedicine, but why aren't workers using it?

CHICAGO – Precious Witherspoon's throat felt raw and her head began to hurt as the workday wore on.

But Witherspoon, an executive assistant at Chicago-based PowerReviews, didn't want to call in sick the next day and haul herself to a doctor's office to hear what she already suspected — that she had strep throat.

Instead, she dialed First Stop Health and described her symptoms to a doctor who sent a prescription to her pharmacy. She paid nothing for the consultation.

"It saved me a lot of extra time and energy," Witherspoon said. She estimates she's used First Stop Health _ offered as a benefit by her employer — at least half a dozen times over the past year.

Employers wish more of their workers would do the same. This fall, more companies are touting so-called telemedicine — in which health care is delivered via phone, video or other technologies — as they gear up for insurance open enrollment. Telemedicine often is offered in addition to or as part of traditional insurance benefits, and some telemedicine companies offer it directly to consumers.

So far, employees haven't warmed to the idea, either because they don't understand it, don't know it's available or because they're skeptical of getting a doctor's opinion via telephone. Telemedicine accounted for only about 1 million of 1.2 billion outpatient medical visits last year, according to brokerage and consultancy Willis Towers Watson.

About 70 percent of large employers offered telemedicine as a benefit this year, but only 3 percent of employees at those companies used the services in the year's first half, according to a survey of 133 companies, each with at least 5,000 employees, released by the National Business Group on Health.

Here's how telemedicine works: A patient requests a consultation either by phone or online. Some companies have agents who take patients' medical histories over the phone before they speak to a doctor, and other companies have patients submit their medical histories online. A doctor then contacts them, asks questions and decides whether to offer a prescription or tell the patient to visit a doctor in person.

The typical telemedicine visit costs consumers about $40 to $49, a fee that is sometimes covered by employers, said Dr. Allan Khoury, a senior health management consultant for Willis Towers Watson. In contrast, before insurance, a primary care doctor visit can cost about $110, an urgent care visit about $150, and an emergency room visit $865, Khoury said.

Insurers might pay for most of those in-person costs, leaving employees with just a copay. Or employees might be stuck with a big chunk, especially if they're on high-deductible plans.

PowerReviews' 140 employees and their family members used the telemedicine benefit 51 times in the first half of this year, saving nearly $6,000 in overall health care costs, said Kira Meinzer, PowerReviews' vice president of human resources.

So given the cost and time savings, why aren't more employees dialing in?

Jason Gorevic, CEO of Texas-based Teladoc, a large telehealth provider, said his company works with employers to educate their workers through welcome kits and seasonal campaigns.

Telemedicine providers like Teladoc and First Stop all have their own models and cost structures. Employers using First Stop Health, for example, pay a monthly fee of $5 per employee and employees get free access to consultations. Companies generally pay Teladoc about $1 a month per employee, and employees then pay up to $45 per general medical consultation.

A lack of awareness, though, may not be the only obstacle to acceptance.

According to a study published in peer-reviewed journal JAMA Dermatology this year, researchers examining 16 teledermatology services found major diagnoses repeatedly were missed and treatments were sometimes at odds with existing guidelines.

Dr. Jack Resneck, the study's lead author, said he wants to make sure that as telemedicine expands, it does so in a high-quality way.