Monday, Jun 12, 2023
Offering Audio-Only Telehealth Can Deliver Tangible Health Equity Benefits
Dr. Anupam GoelMedical Director, Accolade
Someone you see at work every day may be struggling to get the healthcare they need. That's because employer-provided coverage doesn’t ensure access to healthcare. More than one-third of the U.S. population has to travel more than 60 miles to the nearest provider.  People living in these "healthcare deserts" don't have access to basic healthcare services, such as pharmacies, primary care providers, hospitals, trauma centers, mental health resources and low-cost clinics. It’s not surprising that 3.6 million Americans can’t get to providers and get the care they need.  Conditions that could be picked up with screening get missed and early-stage diseases advance to later-stage diseases with higher costs and worse outcomes.
Virtual care can help address access inequities. When you connect to a provider online, your location or lack of transportation becomes less important. Virtual care can insert healthcare providers into healthcare deserts, allowing people to access regular health screenings and mental support check-ins that may find issues before they become more complex. 
But virtual care doesn’t remove health disparities for everyone. While online services and smartphone apps have convinced many that Internet use is ubiquitous, that is not true. Forty percent of adults who make $30,000 or less per year don’t have home broadband services or computers.  If you lack online access at home, you likely rely on a smartphone. Unfortunately, nearly 25% of people earning $30,000 or less (which is about twice the annual earnings of a full-time worker earning the federal minimum wage) don’t own a smartphone.  This means that many Americans may not have the tools or resources to access virtual care. Even if these individuals had access to the Internet, many of them lack the digital literacy to take advantage of virtual care options. 
Reducing healthcare inequalities
Audio-only telehealth allows a person to connect to a provider via telephone. Audio-only services — already being embraced in many states — offer a convenient, affordable, easy-to-use care option.  Being able to pick up a phone and call a provider for an appointment substantially reduces access and technology barriers. It doesn’t matter if you don’t have a broadband connection or if you don’t understand cameras and the microphone on your smartphone. You don’t even need a smartphone. A large fraction of employees facing the digital divide can engage with their health, access over-the-phone medical care and get the support they need.
However, support at the employer- and state-level leaves a significant gap in the ability to increase audio-only telemedicine use. That’s because certain health plan carriers don’t currently provide audio-only benefits or are reverting to pre-COVID coverage models, which means removing coverage for audio-only consultations, except in very limited circumstances.
The benefits of audio-only telehealth
Adding audio-only telehealth to an employee’s benefits plan allows for greater flexibility and privacy when it comes to accessing healthcare.  People can receive care from the comfort of their own homes, even if they live in a healthcare desert or have a physical condition that makes traveling difficult. Employees also are less likely to have to rearrange their schedules because of childcare needs, limited transportation options or work schedules.
The benefits of audio-only telehealth for employees also deliver advantages for employers. Reducing the need for office visits, availability arrangements and travel can improve productivity, presenteeism and efficiency, which has a positive impact on the overall healthcare cost bottom line. This also goes a long way to giving employees an improved healthcare experience, affecting how they view their employer.
Before COVID, the rationale of restricting, or not covering, audio-only telemedicine included a belief that doctors couldn’t meet the standard of care required to diagnosis, treat or prescribe medications for patients. However, the use of telemedicine generally, and relaxed rules related to audio-only telemedicine, showed that doctors could manage audio-only consults effectively within the standard of care. With the standard of care at the core of all consults, the upside to health equity and access to care outweigh the downsides.
Improved healthcare access and engagement
The World Health Organization calls digital health equity a chance to get help and improve health through digital technologies. Virtual healthcare options are a wonderful way to provide that equity. However, it’s also important to name and address the potential gap that comes from not having digital services or access. The industry has a responsibility to address health equity, and employer-sponsored health benefit plans play a big role in this.  Supporting the addition of audio-only telehealth to their employees’ benefits plans is a concrete step toward achieving that goal.
We know that improving healthcare access can improve the health of all your employees. That’s why we’ve engineered health equity into every Accolade solution and care engagement. Our Personalized Healthcare solutions allow employers to address healthcare disparities from an individual and population health viewpoint. So, your people can take better care of themselves, reduce their absenteeism, enhance their productivity and lower healthcare costs for themselves and you. Contact Accolade to learn how our solutions can serve employees across your entire organization.