Spotlight on telehealth

We define telehealth as video or phone consultations with a licensed doctor, including:

• Navigating emergency care or pathways for medical care or behavioral health services
• Diagnosing of non-emergency health issues ranging from acute conditions to complex chronic conditions
• Providing non-emergency pediatric care
• Prescribing medications for common health concerns, when appropriate and medically necessary
• Treating such medical conditions as fever, rash, pain and more
• Making preparations for an upcoming consultation

The pandemic has catapulted telehealth into the spotlight and it’s here to stay. During the pandemic, telehealth enabled employees to access a range of services without having to travel to a health care facility. Additionally, telehealth can be used as a navigation or triage tool to expedite access to effective care, to close gaps in access to care and to improve ease of access to medical care, thus lessening wait time and risk for some patients.

Prevalence

Fifty percent of insurers globally offer telehealth across all plans. Insurers in Europe are most likely to offer telehealth with almost three-fifths reporting that they do so. Telehealth is offered by almost half of insurers (49%) in the Middle East and Africa followed by 46% in Latin America. While only 31% of insurers in Asia Pacific report offering telehealth across all plans, 36% report offering it for select plans.

Figure 1. Prevalence of insurers that offer telehealth across all plans

Services covered under telehealth

Insurers that offer telehealth are most likely to cover primary physician/general practitioner (GP) services, a finding consistent across all regions. Ninety percent of insurers globally offer these services through telehealth.

The other main areas of care under telehealth that this survey examines are prescribing drugs/pharmacy, specialist consultant services and mental health. Results for prescribing drugs/pharmacy are similar to those for primary physician services with an average of 90% of insurers indicating that these services are legally available under telehealth (where they offer the telehealth option), a finding largely consistent across all regions. For specialist consulting and mental health services, there are some differences in Asia Pacific where insurers report lower availability than other regions to offer these services under telehealth. Only two-thirds of insurers in Asia Pacific indicate that specialist consulting or mental health services can be legally offered in that region. In other regions, 85% to 90% of insurers indicate that these services are available under telehealth.

Growth of telehealth utilization

Global perspective

Pre-COVID-19, 54% of insurers globally reported that less than 10% of insured members used telehealth for GP services. Close to a third (31%) indicated that none used telehealth for GP services while only 4% of insurers indicate that this is the case today. At present, 52% of insurers globally report that less than 10% of insured members use telehealth for GP services while 24% say that 10% to 19% use telehealth for these services and another 10% of insurers indicate that 20% to 29% of insured members access GP services via telehealth.

By the end of 2021, 38% of insurers globally expect less than 10% of insured members to be accessing GP services via telehealth while a quarter expect 10% to 19% to do so; almost a fifth (18%) of insurers expect 20% to 29% of covered lives to access GP services in this way.

Regional perspective

Middle East and Africa. There’s been a steady uptick in the use of telehealth to access GP services in the Middle East and Africa. Pre-COVID-19, 69% of insurers reported that none of those covered under their health plans in this region were using telehealth for GP services, a number that falls to 9% today. At present, 53% of insurers indicate that less than 10% of insured members access GP services via telehealth, and almost a third (32%) of insurers say that 10% to 19% are doing so. By the end of 2021, over a quarter of insurers (29%) expect that 20% to 29% of those covered under their plans will use telehealth to access GP services.

Asia Pacific. Pre-COVID-19, 56% of insurers indicated that none of their insured members used telehealth to access GP services, a figure that drops to 4% today. At present, 63% of insurers say that less than 10% are accessing GP services via telehealth, and 21% of insurers indicate that 10% to 19% are doing so. By the end of 2021, a quarter of insurers expect that 20% to 29% of insured members will use telehealth to access GP services.

Latin America. Pre-COVID-19, 68% of insurers indicated that less than 10% of insured members used telehealth to access GP services. Currently, half of insurers report that 10% to 19% of insured members access GP services via telehealth. By the end of 2021, 22% of insurers expect 20% to 29% of insured members to use telehealth to access GP services, and 10% of insurers expect this to be the case for 75% or more of covered lives.

Figure 2. Percentage of covered lives using telehealth for primary physician/GP services – Pre-COVID-19

Figure 3. Percentage of covered lives using telehealth for primary physician/GP services — Currently

Figure 4. Percentage of covered lives using telehealth for primary physician/GP services – Expected by end of 2021

Restrictions

While telehealth in some form has been available for years in many countries, it has not been fully legal in all countries. But the pandemic has helped accelerate the adoption of telehealth. For example, in Brazil where insurers and hospitals had been building up capabilities for some time, telehealth was finally legalized in April. South Africa rushed through its guidance this year.

But even with wider adoption of telehealth, some countries have restrictions in place regarding the services that are legally allowed to be delivered by telehealth. Restrictions can be found in the areas of primary/GP services, prescription drugs, specialist consultations and mental health services.

Pharmacy prescribing is the most commonly restricted service. Some countries won’t permit any prescribing virtually, while others limit the prescribing of certain drugs such as narcotics. Countries with pharmacy restrictions include Brazil, the Netherlands, Spain, Switzerland, India, Indonesia, Japan, the Philippines and Taiwan.

Regarding restrictions related to primary/GP services, some countries may limit these services to follow-up visits as is the case in Japan. Certain countries limit specialist consultations to certain specialty areas. Finally, when it comes to mental health services, there may be restrictions on the conditions that can be treated via telehealth.

The legislative situation regarding telehealth is very much in flux right now. Consequently, it’s important to stay current with telehealth legislation around the globe. At the same time, employers should be looking for ways to ensure they incorporate telehealth delivery into existing medical programs and not offering it as a duplicative service.