Telehealth: Making health care more accessible and affordable

By Avihai Sodri

In the late 1970s and early 1980s, the U.S. health care system was widely regarded as the best in the world. Today, although the U.S. health care system remains preeminent, it has, without question, become the most expensive system in the world.

U.S. health care spending reached $4.5 trillion or $13,493 per person in 2022, accounting for 17.3% of the nation’s Gross Domestic Product. For perspective, health spending per person in the U.S. is nearly two times higher than in Germany and four times higher than in South Korea. Not only is this system too expensive for the average American, but it is also inaccessible. A lack of providers means that people regularly face long waiting periods to receive care.

Health insurance companies must recognize that these efficiencies won’t go away by following the status quo. As such, they should use innovative approaches, such as telehealth, to provide their members with accessible and affordable health insurance and care, regardless of financial or geographical constraints.

Enhancing accessibility and reducing wait times

Telehealth and other online services allow members to access health care faster. One health insurance company uses telehealth to provide its members access to their primary care physicians in a few hours, including 24/7 access to additional physicians and clinicians if the member’s PCP is unavailable.

Telehealth also helps members more efficiently and conveniently manage chronic conditions, especially those living in rural communities where specialist care is often scarce. By offering virtual consultations, insurance companies can ensure their members receive care without experiencing long delays. With remote monitoring tools, such as blood glucose monitors and wearable heart monitors, insurers can also help members keep chronic conditions under control.

Another advantage of telehealth is that it increases the accessibility of mental health resources and counseling, opening doors to communities that would otherwise be unable to receive care due to geographical barriers. In the past, mental health resources were limited and not readily obtainable – however, through telehealth, insurers can make a meaningful contribution to addressing the nation’s ongoing mental health crisis.

Making health care more affordable

In addition to enhancing health care accessibility, telehealth can make care more affordable. Telehealth supports proactive care measures, which reduce long-term health care costs and decrease the burden on the health care system. This ultimately allows insurers to cut costs and offer more affordable premiums.

For example, during a telehealth visit, an insurer gathers real-time information on a member’s health, enabling the insurer to identify pressing needs and risk factors proactively. With this data, the insurer can suggest personalized care plans and schedule routine virtual check-ups, preventing the member’s conditions from worsening. This minimizes expensive treatments and hospitalizations. In contrast, traditional insurance models (including in-person visits, which require weeks to months of waiting) often retroactively identify health needs and risk factors, forcing them to chase down the member after too much time has elapsed.

This real-time data also enables insurers to provide tailored guidance to their members, empowering them to make cost-effective decisions when consuming health services. For instance, members can avoid unnecessary out-of-pocket expenses by receiving proper referrals.

True system change requires meaningful innovation

There are fundamental issues within the U.S. health care system. Insurance companies must make significant changes to their culture and infrastructure to be more proactive and involved in their members’ day-to-day health.

By adopting methods such as telehealth, insurers can make substantial progress in delivering accessible, affordable and high-quality care. But beyond integrating innovative technologies and techniques, insurance companies must treat these efforts as more than fleeting post-pandemic trends or fads but as an intrinsic part of the necessary evolution in the healthcare industry.

Avihai Sodri is CEO and cofounder of Antidote Health. Contact him at [email protected].