What the tele-hell(th)

Yes I know it’s spelled wrong but it’s the only way it made sense in my head…

Hi friends! And welcome to the 6 new ‘sexy healthcare-ians’ that subscribed this week! (props if you can help me come up with a catchier term to call you guys :) )


Based on the title, I’ll give you 2 guesses about what this week’s newsletter is about. Ready? Go!

Right...telehealth. I’m going to attempt to break down the basics of telehealth and why it matters, in both a fun and exciting way. The pressure is on.

BUT before we begin, I want to highlight a quote from one of my favorite healthcare resources on the market… the Bio Eats World podcast from a16z. If you want to listen to the whole episode, which I highly recommend, I've included it in the ‘recommended resources’ section at the bottom. 

“Healthcare is a little strange industry in that in many ways of course it's built entirely for and around the patient and yet the patient is in a lot of ways not the end point customer. The patient is unfortunately often overlooked in the business flow between a huge system of providers, clinical workflows, insurance payments and reimbursement.” - We, the Patients. Bio Eats World.

GAH! They get it! It warms my little heart when an organization as big and well known as a16z understands the lack of consumerism in healthcare and is working to create a conversation around changing it. Props humans. Props.  

Now, onto the main topic. Telehealth. How many of you have heard of telehealth? Yes? Awesome. No? It’s okay. Think of, having a visit with your doc completely through Zoom. Never heard of zoom? Well then I hereby give you permission to return to the rock underneath which you’ve been living. 

Okay so...what IS telehealth? 

Telehealth is includes services administered by pharmacists, nurses, and social workers. That are remote healthcare services beyond what a doctor does. They evaluate and help with the patient’s health and medication needs as well as troubleshoot health issues and detect changes in medical conditions. It can include phone calls, secure messaging, video visits, even remote monitoring where you share some of your data via secure platform.( Our Community Now)

Let’s further convolute shall we? Well, there’s also telemedicine, telecare, and virtual visits. 

Telemedicine is when licensed doctors and healthcare providers use the same technology to deliver medical and treatment-related information to patients. PHI private stuff... They’ll use tech to talk with you, monitor symptoms and progress, and deliver evaluations, as well as provide access to specialists. (Our Community Now)

DID I LOSE YOU?! STICK WITH ME….

Telecare is just the actual technology itself (the app). It’s the tech that allows the patient to stay safe and healthy in their own home, things like health and fitness apps, sensors, fitness tracking tools, medical alert systems, and digital medication reminders. (Our Community Now)

Virtual visits then, are just any online communication. It can even be with a health coach or non-licensed provider. These are typically found in lifestyle medicine membership models and included in the program offering itself.

Now I reaaalllllyy don’t need to go into the insurgence of telehealth during the pandemic buuuttt well okay yes I’m going to. Why? Because it’s relevant and it segways into my next point. I swear. Dear soapbox…

Telehealth has actually been around since the  1940s (yup!) where radiology images were sent 24 miles between 2 Pennsylvania townships via telephone line in the world’s first electronic medical records transfer! Interesting! Well I thought so.. 

Okay obviously things have come along way since then.

Patients trying to access telehealth have DOUBLED since the beginning of the year (154% in march alone!), which was up already significantly from the year before. Still though, the utilization numbers are quite small. Lack of resources? Lack of knowledge of options? Lack of tech savvy? Just sheer stubbornness of not wanting to see docs (ehh hem - men) we’ll never know. 

What you might know about about your options here

Basically everyone has access to some sort of telehealth service these days! Through their employer or standalone providers. And while there are still some flaws, it’s a huge step forward in a few ways. Like, providing access to rural communities where driving to a doc office was much less doable then hopping on your phone. For providing elderly seniors with a way to communicate with a physician without having to risk injury. For providing EVERYONE a less risky way to take care of routine medical appts during covid than going into a highly contagious office environment. You can do physicals, check ups, acute illness visits, well visits, mental health visits, you name it. But not everything; Like catastrophic care, in hospital testing or doctor monitoring on premise stays. (I’m still waiting on Elon Musk to send me a way to mend a broken leg via iPhone…it’s coming trust me)

Now, what you might NOT know about your options  

Telehealth is one of the first healthcare services to go retail. What do I mean? Direct to consumer. Like so many services that will follow. Non healthcare companies have popped up, along with the standalone providers, that offer secure ways to have video conversations...with relaxed laws during 2020, platforms like Zoom and Facetime were approved to facilitate virtual visits. But when you might think that telehealth was a service put in place as a response to the COVID19 pandemic, in fact no! It was just emphasized as a new solution. Telehealth wasn’t created at first to be a ‘convenience tool’ for patients...it was created to be a cost saver for providers and payers. It costs significantly less to operate and to not have a patient not come into a hospital for services.

Not to mention, when you get on a video call with a physician, it’s 99 out of 100 times NOT your own primary care doctor! It’s a random physician that works for the platform. Basically the telehealth industry is more like the gig economy. And you’re in a triage conveyor belt of sorts.

So essentially… you’ll spend most of your time going over your past medical history or filling out online forms, if they don’t have the data transferred directly in front of them. 

And EVERYONE is working on jumping in the me too telemedicine movement, heck, even Sam's club members’ can jump on a doc video visits for a big buck! … no literally for $1.

Its still raises questions. Does it really cut costs? Are outcomes better? Do patient experiences increase? Doubtful. BUT While there are pros and cons to this solution, only 1 thing matters...how you can use it to help you, because it’s here to stay. Continue my friends...

What’s a savvy way to utilize telehealth and how can you learn more?

Okay so… we’ve gone over some basics of what it is and if I put my psychic hat on I’m saying most of you have used it out of convenience or necessity. Now, here are some ways you can be more SAVVY in your use of telemedicine. 

Studies are showing that during the pandemic, many people have opted OUT of getting service all together because of fear of contracting or being exposed to COVID. Now, again assumptions...but I’m thinking it’s because either they don’t know about telehealth and if it’s covered by their insurance OR they don’t have insurance at all and don’t know about resources to get cash pay visits.

So here’s tip 1 - use this as a resource instead of forgoing treatment all together! Check to see if telehealth is covered by your insurance if you have it. In most cases YES it is. Especially now and especially if you’re covered by employer sponsored insurance. As a result of the pandemic, most plans have opted to increase and expand coverage of telehealth visits and therapies due to its prominence (a shockingly great response by the gov).

Here’s an easy way to do so… if you have insurance, you have an insurance card with a subscriber number. Most often, your insurance carrier has resource portals. You login, search your plan by subscriber number, and view your benefit information. Telehealth will most likely either be listed at ‘fully covered’ (so free.99, ‘deductible/coinsurance’ ( meaning you pay the full price until you reach your deductible then your coinsurance % will kick in ) or, listed at a copay, which is a flat fee per time used (like $25-$40 I’ve seen most often). If you find that a telehealth visit is NOT covered…move to tip 2.

Tip 2 - opt for a standalone telehealth provider. To double check if it’s covered by any insurance, if you’re going with one of the most popular like Teladoc or MDLive, you can login to the account you just created with them and enter your insurance subscriber ID to see if your plan covers the visit you’re about to have.

OR if not, you can pay face value of the visit. Which nowadays with the prominence of D2C healthcare, most standalone providers have increased price transparency of their services included right on their website. I’ll list out a few of the top stand alone telehealth providers here:

MeMD, Amwell, Dr on Demand, PlushCare

Tip 3 - let’s assume you’re NOT covered by insurance at all. You're an entrepreneur, small biz owner or freelancer that relies only on cash pay healthcare (what’s that you ask, never fear, the Sexy Healthcare newsletter is here! Down the road I’ll be unveiling all about how you can supplement your care with cash pay services) anywhoo...here’s what you do. You explore membership with online membership primary care businesses. Why? Simple. They’re effective. If an organization is a primary care online cash pay model, it’s most likely because their services aren’t reimbursable by insurance. Which means they most likely are lifestyle or functional medicine based. These primary care providers offer more than just routine physicals. their telehealth visits can also include coaching from a certified health coach, lifestyle guidance, and more. Now, the cost of these ranges heavily, so I’d recommend doing research. But one of the biggest and best models I know...is Parsley. And they do virtual visits and tele-consults. Check them out to see what I mean. www.parsleyhealth.com

Now to blow your mind a bit more, here are some of the most prominent D2C healthcare companies that have added virtual visits to their repertoire in response to the great debacle that was 2020. 

Hims and Hers, Ro and Rory, GoodRx, Lemonaid, Brightside, Virta, and MANY more.

Tip 4 - How to pay for it. DID YOU KNOW...Whether you have insurance or not and if you do have insurance, telehealth isn’t covered, don’t fret...there are some savings methods you can use to cover the cost . The most prominent way to pay (if they do cost anything) is just out of the good ol’ pocket or savings account, or, if you’ve opened what’s called a Health Savings Account through your employer , you can use that too.

Now let’s jump in the DeLorean again quickly and examine what the future of this relationship COULD look like! We the consumers, have the power of choice. We schedule a visit with the doctor of our choosing...probably in our geographic vicinity because we know that there will be times we need to be in person. The relationship is already kicked off, by way of a secure sharing of healthcare data across providers so they already know your history. Your lifestyle data is already available for them via wearable integration or otherwise, so they know everything about you before you speak. They go over our post visit and prescribe lifestyle changes, or if needed an Rx that can be also securely delivered to your door. You are the center and the system operates around you. Sounds nice???? I know.

Phew okay. Now I know a lot of this sparks more questions, but you can always comment or reply to his newsletter and ask away! I’m going to bed now. 

This week’s recommended resources - 

A16z bio eats world podcast - https://a16z.com/bio-eats-world-podcast/

PCORI - https://www.pcori.org/

(Refer to all the standalone providers mentioned above)

Have any thoughts or suggestions about this or any past newsletter? Want a topic covered or question answered? Or shoot, even if you want to CORRECT me! Comment below or hit ‘reply’ directly to the newsletter!

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(remember, this in no way serves as medical, financial or legal advice)

To making healthcare sexy again,

-Nikki 

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