NY BlueCross To Cover Telehealth Services

BlueCross BlueShield of Western New York and Blue Shield of Northeastern New York will soon begin covering telehealth services for patients who connect with healthcare providers from home or work via the American Well Online Care platform.

In general, American Well's Online Care services allow patients to access healthcare providers via the Web or phone 24 by 7, without a pre-booked appointment.

However, in the initial roll out of the American Well services covered by BCBSWNY/BSNENY -- which are divisions of one upstate New York payer organization, HealthNo -- telehealth care will be available from BCBSWNY and BSNENY network providers during times set up by the doctor, such as pre-office hours or in the evening.

Patients may connect with these doctors via the Web or phone and doctors will be reimbursed by BCBSWNY/BSNENY for these services.

The initial launch of Online Care will occur in western New York with service to northeastern New York expected by fourth quarter 2010. The first phase of the initiative will offer Online Care to eligible BCBSWNY/BSNENY members. However, the services will later be expanded to non-members and the uninsured throughout New York State.

The services will help fill a healthcare services gap in upstate New York, where there are shortages of primary care doctors, said Dr. Cynthia A. Ambres, senior VP and chief medical officer for BCBSWNY/BSNENY.

"I think we're addressing a real access issue," said Ambres. BCBSWNY/BSNENY is one of a small but growing number of health insurance companies and health plans in the U.S. that are starting to pay doctors for various telehealth services they provide to patients.

"More and more patients can't get an office appointment with a doctor," because of shortages, Ambres said. For urgent, but non-emergency situations, the American Well Online Care platform lets doctors and patients communicate in brief encounters that can help put patients' minds at ease, or direct them to needed treatment. For instance, the doctors can electronically send prescriptions for patients to have filled or instruct them to seek follow up care with another physician.

Online Care encounters can take place via the Web -- including webcam-enabled exams or chat--or by phone.

American Well has signed similar pacts with a number of insurers in other regions of the country, including Hawaii, so that patients have access to healthcare providers on the U.S. mainland, or elsewhere.

However, the new arrangements with BCBSWNY/BSNENY represent the first health insurer in the northeast region of the U.S. covering telehealth services provided by American Well.