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Industry Insights

Moore: Is Workers' Comp Telehealth Still Worth the Time and Expense?

  • National

A few workers' comp telehealth articles have appeared recently in the blogosphere. I titled this article telemedicine. Then I read the somewhat outdated article on the Centers for Disease Control and Prevention's website. You can check it out here.

James Moore

James Moore

The CDC’s comments on telehealth:

The use of telehealth has expanded exponentially since the late 1990s, and current projections indicate that its use will occupy a $30 billion corner of the health care market by 2020, an increase of $20.4 billion since 2013. Among rural Medicare recipients alone, the number of telemedicine visits increased from just over 7,000 in 2004 to nearly 108,000 in 2013.   

I wanted to explore the whole market for telemedicine and then slice out the workers' comp piece of the overall market. An archived article from the CDC pointed out a few salient points; the first one is an interesting thought for workers' comp telehealth.

These are potential limitations of telehealth:

  • Interstate licensure challenges and other regulatory issues that may vary by state.
  • Situations in which in-person visits are more appropriate due to urgency, underlying health conditions or inability to perform an adequate physical exam.
  • The need to address sensitive topics, especially if there is patient discomfort or concern for privacy.
  • Limited access to technological devices (e.g., smartphone, tablet, computer) needed for a telehealth visit, or connectivity issues.
  • Level of comfort with technology for the health care providers and patients.
  • Cultural acceptance of conducting virtual visits in lieu of in-person visits by providers and patients.

The first two points are bolded for a reason. These conundrums have occurred in files we have reviewed since the beginning of the pandemic.

We also saw a lengthening of temporary total disability periods as the workers' comp claimants would not attend in-person office visits to be rated and released. If this issue was challenged by the workers' comp adjusters, the judges would allow waiting until the pandemic subsided overall.

A good page that would familiarize injured workers with workers' comp telemedicine was provided by the Department of Health and Human Services, here.

My experience with telemedicine

I attended one office visit in 2020 using my laptop. I wrote an article on the visit.

I found it to be OK if (big IF) no type of physical exam is required at the appointment. My appointment was to review lab work with a specialist. It was perfect for my situation.

Physical medicine appointments with specialists such as orthopedists would seem to require an in-person visit.

I thought I would see what any of the rating bureaus had on telemedicine use during the pandemic. This chart from page 46 of the Workers' Compensation Insurance Rating Bureau's 2021 State of the State presentation showed the amazing increase in telehealth visits.

The third point in the chart shows that telehealth could be a viable option going forward:

The average use of telemedicine services started to stabilize in the third quarter of 2020 but remained approximately
40 times higher than the 2019 level.

Will we go completely back to the old methods of workers' comp medical treatment, or will telehealth be a viable option for the long run? Look at the chart above again to see a viable market.

This blog post is provided by James Moore, AIC, MBA, ChFC, ARM, and is republished with permission from J&L Risk Management Consultants. Visit the full website at www.cutcompcosts.com.

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