Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Telehealth: Saving the Health Insurance Industry


Published on

There could not be a more timely benefit program than telehealth. An estimated 100 million Americans will be enrolled in a telehealth benefits plan by 2015. What are you doing to help these people?

Please review the attached Powerpoint then lets get you contracted to get this out to your clients ASAP!

  • Be the first to comment

  • Be the first to like this

Telehealth: Saving the Health Insurance Industry

  1. 1. Telehealth: Saving the Health Insurance IndustryPresented by:Wavefront Brokerage Services Presented by1(888) Brokerage Services WaveFront
  2. 2. Are you seeking to uncover more business leads but tired of the lack of quality or high costs? Tips, Tools and Resources for Uncovering Endless Business Leads Effectively using FREEERISA, Linkedin, Slideshare, Eyejot, and ReferenceUSA Wednesdays @ 9 AM PT; 10 AM MT; 11 AM CT; 12 PM ET Conference Call Dial: 1(559) 546-1200 Access Code: 329-586-701#
  3. 3. This presentation is NOT to make you smarter;this presentation is to make you SUCCESSFUL!
  4. 4. The System Is BrokenIt doesn’t matter who Presented by we’ve all felt the pain you are,of the current healthcare system and we feel in the WaveFront Brokerage Servicescore of our being that there has to be a better way!
  5. 5. According to a recent MetLife study… Two thirds of bankruptcies today stem from medical debt. Of those, 78% had medical insurance but went bankrupt any way due to preexisting conditions, out-of-network visits, high co-pays or services not covered under Presented by their insurance. Many people may WaveFront Brokerage insurance themselves but be covered by health Services unable to afford the cost of cover their entire household which can again create a ton of exposure to financial strainBankruptcy issues severely affect the workforce – producing poor work, more time off, emotional problems and more
  6. 6. Some Key Stats…19.5% Of USA’s GDP will be spent on healthcare by 2017 US Health & Human Services Dept.76% Of the time Doctors offices are closed during week 3 Average wait time to make a doctor appointmentweeks 23min. Average wait time in physician’s waiting room75 to Of Doctor’s visits originate from stress factors90%
  7. 7. Did You Know… Top 3 ER visits in 2012 were Ear,Sinus, Upper Respiratory InfectionsNot broken bones or car accidents American Medical Association
  8. 8. Did You Know…4 of 5 of all ER, urgent care,and doctor office visits could be better handled over the phone…safely and effectively. American Medical Association
  9. 9. Did You Know… 92% of consultations with CADRPlus doctors areresolved without the need for a follow-up.89% of healthcare executives believe telemedicine will transform healthcare.*Cell Phone Medicine
  10. 10. Growth of TelemedicineBy 2015 Industry experts realistically foresee100 million individuals/yearaccessing virtual care services like telemedicine.This level of growth mirrors the development ofthe popular MinuteClinic model, which had lessthan 100,000 visits in 2006and in late 2011 grew to more than Telemedicine, means using information and10 million visits/year communications technologies for the delivery of healthcare services.
  11. 11. Trend: Rapid Growth of Telemedicine100+ Carriers across 26 states Widely reimbursable and becoming fullyreimburse for telemedicine: integrated into the delivery systems and benefit offerings of major health plans and self-funded groups. States with legislative mandates: California Colorado Georgia Hawaii Kentucky Louisiana Maine New Hampshire Oklahoma Oregon Texas Virginia Maryland Vermont Michigan And Growing…PREDICTION- ALL MAJOR PLANS 50 STATES – 36 MONTHS
  12. 12. Why Now?The Affordable Care Act (ACA) specifically mentions telemedicine as a tool to improve access and information delivery as part of the focus on more cost-effective care delivery Healthcare now a right/obligation for all by 2014  ~ 20% of Americans currently uninsured  Likely to increase strain on already-strained system Estimated 100,000 doctor shortfall by 2025  NYTimes Article: Doctor Shortage Likely to Worsen With Health Law Anticipated 1/3 of hospitals close by 2020  David Houle and Jonathan Fleece
  13. 13. TELEHEALTH IS THE ANSWER AND IS THE VERY BEST BUNDLE AVAILABLE!• It’s convenient – 24/7 access from anywhere• It’s unlimited – no hidden fees or per-use charges• It’s easy – just call or click and you’re connected• It’s quality – Masters- level Clinicians, US Board Certified Doctors, Vetted Partners/Resources• It’s proven – our partners have over 3 million members and counting• It’s comprehensive – for the body, mind and pocket book• It’s affordable - $15/mo. PMPM for individuals; $10/mo. for groups
  14. 14. Understanding the Telehealth LandscapeThere are 3 main providers of telemedicine services: Virtually every other company offering telemedicine benefits is a ‘white-labeled’ carrier for one of these 3 providers Presented by such as: WaveFront Brokerage Services There are some significant differences in the platforms, plan offerings, quality of services, and cost.
  15. 15. • Low-PEPM of $2 - $5 (Physician • Employee + Family $30/month • Employee + Family $10/month consult = $38/consult; Wellness (Unlimited usage; no fees) (Unlimited usage; no fees) consult = $27/consult)• 2 - 12% utilization rate • 18 % utilization rate • 26+% utilization rate nationally (lowest in nation)• Avg. Physician response time: • Avg Physician response time: • Avg. Physician response time: up to 3 hrs. 24 mins. 90 secs.• Consultations available by • Presented by Consultations available by • Consultations available by telephone only after going telephone, internet and video. telephone, internet, video, online prior. WaveFront Brokerage Services smart phone app, secure email, chat, and text msg.• No recording of consultations • Record consultations and post • Record consultations and post to personal health record. to personal health record.• SureScripts Access – No. • SureScripts Access – No. • SureScripts Access – Yes.• Secure Email Consultations – • Secure Email Consultations – • SecureEmail Consultations – No. No. Yes. • 2,000 GP Physician network (not • Nation’s largest physician• Very modest physician enough physicians to handle current network; includes specialists network (reason physician rate of enrollments) (ONLY Physician Network equipped to response time slowest) handle current rate of enrollments).
  16. 16. Key Differentiators Between CADRPlus and the CompetitionThe lowest cost, highestphysician? Because we understand that members 1. How can members connect with a impact soluction to many ofthe issues plaguing we havehealthcarethem to connect to CADR. They use technology differently the multiple ways for system today. can call our care center; request a call from a physician via the member portal, secure email, chat, video, mobile application and, of course, telephone. Others require that members go online first; we understand that not all will have access to a computer or the internet so this is not a requirement. 2. Education/Communication: Driving utilization is what makes us superior to our competition. Across our book of business, CADR boasts a 26+% utilization rate for clients that have been with us for at least 12 months. We will work with your company to understand how to best work with your different employee populations. This can consist of email blasts, phone mail messages, mailers, hard copy flyers, posters, etc. 3. A member can be on the phone with one of our physicians in less than 90 seconds. When deciding whether to go to a higher cost setting or whether a condition can be handled via telemedicine this is key. No other telemedicine company has this functionality.
  17. 17. Key Differentiators Between CADRPlus and the CompetitionThe lowest cost, highest impact soluction to many ofthe issues only telemedicine organization that has thesystem today. all 4. We are the plaguing the healthcare unlimited plan which includes consultations. 5. We are the only telemedicine organization that records all consultations and attaches it to the personal health record of our patients. We do this not only for patient history but as a tool for quality control. 6. We are the only telemedicine organization that has access to SureScripts which allows us to see 24 months of prescriptive history for our patients. This is available whether or not the prescription has been prescribed through CADR or another physician. 7. CADR physicians have access to the patient’s formulary through SureScripts. 8. We provide secure email consultations; Teladoc does not.
  18. 18. Simply put…The lowest cost, highest impact soluction to many ofthe issues plaguing the healthcare system today. The lowest cost, highest impact solution to many of the issues plaguing all Employers, Employees and the healthcare system.
  19. 19. You are in Good Company with
  20. 20. So, how does this program work?The lowest cost, highest impact soluction to many ofthe issues plaguing the healthcare system today. + = + +
  21. 21. Access to the nation’s premiere and largest network of licensed, board certifieddoctors & specialists anytime, anywhere – day or night; no one is denied, andthere is no waiting, period.Multiple Ways to ConsultCADR+ provides a technology andservice platform which allows students& staff to consult with physiciansvia Telephone, Mobile APP, Video, On-line, Email & Text,on an immediate basis, 24/7/365 AND receive a refill orprescription for their illness…ready when they are! Give them a call and you will be connected within 2 minutes!
  22. 22. Multiple Ways to Consult
  23. 23. More Quality TimeAverage time spent with a Doctorduring a traditional office visit isonly 4 minutes Average time spent with a Doctor during a Consultation is over 15 minutes
  24. 24. National Telemedicine Physician NetworkTelemedicine Services Enterprise Platform PLUS CADR’s National Network of Primary Care Physicians  50 State PCP Provider Network  U.S.-based, Board Certified/Eligible  Credentialed to NCQA Standards  170 Languages Supported  On-Demand (24/7) Via Secure Phone, Web (Video/Email) or Mobile App  Additional Specialties Now Online:  Pediatrics, Cardiology, OB/GYN  Mental Health, Endocrinology
  25. 25. Quality Assurance & Patient Safety Continuous Quality Improvement process as a tool to monitor, analyze and improve the medical care delivery mechanisms practiced by Consult A Doctor physicians 100% of consults are documented and recorded; controlled substances never prescribed Regular CQI Medical Records Reviews are performed consisting of at least 3 initial priority consultations for each new doctor and at least 10% of randomly selected priority consultations per week for existing physicians Weekly CQI Audio Recording Reviews consisting of 3 initial priority consultations for new doctors and 2 random priority consultations for existing doctors per week
  26. 26. 9 Most Common Reasons People Visit a Doctor, Urgent Care or Emergency 1. Allergies Doctors 2. Bronchitis address 3. Earache 4. Sore Throat the top 9 most 5. Pink Eye common 6. Sinusitis reasons for a 7. Strep Throat visit to the 8. Upper Respiratory Infections doctor 9. Urinary Tract Infections AND MORE!
  27. 27. Employee Experience Provide CADR+Call CADR+ to medical schedules call request a with anconsultation history appropriate doctor Doctor reviews the online patient Member history and calls receives the member* follow-up survey call If prescription is Doctor updates required Doctor Call recording EMR with calls in Rx to is posted consultation member’s choice of notes pharmacy *Average on-call response time by a physician is 2 minutes! Fastest in the nation.
  28. 28. Member/Patient Portal+ HIPAA Compliant+ Web-based for convenient access+ Simple to use+ Electronic Medical Records+ Send emails to doctors+ Upload pictures to send to Doctor or for reference+ View Doctor’s notes and follow-up communications immediately after consultation+ All calls and video consultations are recorded and stored for accurate history and reference
  29. 29. My Message Center Send and receive secure emails to a licensed physician forMy Consult Center confidential and convenient information. Receive labSchedule appointments, e-mail a requisitions and, store and forward your medicalhistory to your primary care physicianand more.My Health Center My Symptom CheckerSymptom Checker, Health Evaluate symptoms andLibrary, Interactive Health Tools recommend treatment options
  30. 30. – Mobile Apps My Health Center First Aid Medications Medical Tests / Labs Wellness Chronic Condition Management Challenges Rewards Support Groups
  31. 31. ePrescriptions Features / Benefits Electronic prescribing  Less errors  Surescripts  RX history  Med2Med interaction  Decision support  Evidence based Pharmacy of choice  By home, work, hotel, school  Less wait  Formularies  Insurance Documented in EMR Reported to PCP/Plan
  32. 32. Follow Up/Referral Post Consult Benefits  Follow up care instructions  Telemedicine consultations  In-person referrals  Patient education  Scheduled messages/reminders  Diagnostic labs  Health tracking tools  Health risk assessments  Coding  CPT  ICD-9
  33. 33. Follow Up/Referral Through the use of next-stage technology CADR partners with Payers to enhance and support their care management and cost containment approach Data integration between CADR and Payer provides health related information to providers and patients at the point of care to Data Sources improve clinical outcomes Paid Claims Data Laboratory Results CADR’s data warehouse serves as the Prescriptions central repository of data derived from Health Risk Assessments numerous sources Evidence – Based Raw data becomes critical information Clinical Guidelines readily available to effectively manage care Member & Provider Communications
  34. 34. Key Stats… 90 Average on call physician response time sec15+ min Average consultation duration92% Avoided a doctor office visit, Urgent Care or ER visit100% QA follow up with patient, within 72 hours of consult98% Reported being very satisfied with their consult (highest in the industry)
  35. 35. Additional Member Benefits Resources For Living Employee Assistance Program (EAP)• Customized EAP (Employee Assistance Program), Work/Life & Concierge Services supporting all facets of your life.• UNLIMITED telephonic consultation.• 24/7 access to vetted life coaches, counselors & professionals handling issues such as crisis counseling, legal, financial, ID theft, life coaching & work issues.• 100% private, confidential• Tailored for personal needs, plan of attack• 170 languages supported• Online Resource Center
  36. 36. THE STRESS EFFECT Over 1/2 of Americans self-report that they are “struggling” with life today and 1/3 state their average stress level as “extreme”. 75 – 90% of doctor visits are considered to be stress-related. Stress is linked to all of the leading causes of death including heart disease, cancer, accidents and suicide. The World Health Organization estimates that the equivalent of 7.1 productive days are lost per employee each year due to stress-related factors. 25 million Americans will have an episode of major depression this year alone.
  37. 37. TELEPHONIC CONSULTATION Unlimited access Masters-level clinicians Available 24/7 Live Answer Confidential Service 170 Languages Crisis Support
  38. 38. LEGAL & FINANCIAL SERVICES Telephonic or face to face attorney consultations*  Domestic/family, civil, landlord/tenant, criminal, estate planning, immigration, motor vehicle, etc. Free online will for all eligible dependents  Simple Wills, Power of Attorneys, Living Wills Telephonic financial consultations*  Tuition/investment/tax planning, debt and loan consolidation, mortgage and refinancing. Telephonic fraud resolution consultation  Provided by Certified Fraud Resolution Specialist*First 30 minutes free per issue, unlimited issues
  39. 39. Resources For LivingHow it Works: Give it a TRY!Phone Number 1-877-856-1788Website Login: CADRPdemo Password: demo
  40. 40. PATIENT ADVOCACY• The Karis Group• For hospital and medical balances $2,500 and up• Negotiates on your behalf to reduce balance; set up a payment plan; or establish final payment• Drives down cost significantly (national average cost savings 50%)
  41. 41. Surgery SaverDesigned for self-insuredemployers. We shop prices forsurgery procedures and suggestlowest cost/best value forcomparable services before thesurgery takes place, providingPlan Member with a briefsummary of available options.Metrics: typical 300-400% ROI
  42. 42. A free prescription and health care discount cardthat provides access to savings on a wide range ofhealth care products and services, includingprescription drugs, lab tests, vision care and dentalcare.
  43. 43. SIGNIFICANT SAVINGS• Pharmacy Savings – save up to 65%• Dental Care – save up to 50%• Vision Care – save up to 50%• Hearing – save up to 15%• Lab Savings – save up to 60%• MRI & Imaging – save up to 70%• And more!
  44. 44. Pick Your Plan Families & Group Group Individuals Voluntary Sponsored Unlimited, 24/7 Access Unlimited, 24/7 Access Unlimited, 24/7 Access Individual Enrollment Multiple Groups Multiple GroupsCredit Card or Bank Payment Opt-In Enrollment/Payroll Deduct Whole Group Enrollment Up to 6 Family Members Up to 6 Family Members Up to 6 Family Members $14.95/month $12.95/month $10/month NO Underwriting, ALL Qualify – Pre-existing Conditions Included
  45. 45. Benefits ofYour + High value benefit for low cost + Less hours missed for doctor appointmentsCompany + + Fewer sick days taken Healthier workforce + Easy for your employees to address health needs + Measurable reductions in healthcare costs healthier employees + Reductions in health risk factors better quality of work fewer missed days + Improved employee awareness and higher productivity engagement workplace wellbeing
  46. 46. Employer Cost Savings The savings for an employer comes by way of five components: 1. Through employee utilization and participation fewer claims are paid and therefore less insurance is used. This impacts cost differently depending on the plan the employer is providing to his employees. a) If you are self insured with a stop loss, every month you are paying your own claims up to the cap. Even if your claims are small one month you continue to pay in the larger amount creating a reserve for unknown future use. CADR+ impact: Reduction in claims via CADR+ means less to payout and less to reserve, the impact is immediate. b) If you are fully insured, less insurance is used annually. CADR+ impact: At the end of the year the insurance company’s rate renewal will effect the reduction in insurance used and therefore the rate renewal will be less.
  47. 47. Employer Cost Savings 2) Part of insurance cost is driven by administration. There is a cost to administer claims regardless of size. The reason why higher employer deductible plans are less expensive than lower deductible plans is because of the claims administration. Higher deductible plans mean fewer claims to administer. CADR+ impact: Using the CADR+ system eliminates a substantial portion of the number of claims to administer providing cost savings. 3) Productivity and fewer hours missed from work. We know that people will take time off to see a doctor when sick for either themselves or a family member. Typically we compute that to be a half day or 4 hours. CADR+ impact: We are confident that time-off is reduced through the convenience and immediacy of telemedicine.
  48. 48. Employer Cost Savings 4) Wellness in general. CADR+ impact: Early medical intervention means better medical results, which computes to a healthier more productive workforce. This is the foundation of all the wellness programs in the marketplace. The difference with CADR+ is that it doesn’t require long term behavioral change to take place to affect cost. Cost can be affected immediately through it’s use. 5) 45% of all employee absences are driven by some mental debilitation/problem; yes we can get sick when we are stressed and dealing with non work related problems. CADR+ impact: The ability to speak with a licensed clinical social worker 24/7 and unload those burdens will keep people healthier and more productive. People do come to work distracted and in a funk….CADR+ can help them through their personal, financial or legal problems with just a phone call.
  49. 49. Cloud Based Telemedicine SolutionsContracting is Very SimpleCommissions are Very High (residual month in by Presented month out) WaveFront Brokerage Services Need to know more? Wavefront Brokerage Services 1(888) 544-6640
  50. 50. Cloud Based Telemedicine SolutionsWould you like to take a 30-day FREE test drive? Presented by WaveFront Brokerage Services Wavefront Brokerage Services 1(888) 544-6640