This document discusses the growing use and benefits of telemedicine. It notes that telemedicine reduces costs, improves access to healthcare especially in rural areas, and can help reduce employee absenteeism for businesses. The document also outlines the projected rapid growth of telemedicine and increasing acceptance by both younger and older groups as well as how advisors can help consumers and businesses take advantage of telemedicine options.

1. A New Era for Individual Advisors & Business Consultants
DocDial Managing Partners; Steve Dodder & Mel Schlesinger
Telehealth + Health
Advocacy
Mel Schlesinger

2. What is Telemedicine?
 From the American Telemedicine Association:
“Formally defined, telemedicine is the use of medical
information exchanged from one site to another via
electronic communications to improve a patient’s
clinical health status. Telemedicine includes a
growing variety of applications and services using
two-way video, email, smart phones, wireless tools
and other forms of telecommunications technology.”
http://www.americantelemed.org/about-telemedicine/what-is-telemedicine#.VP-qNuEi_nQ
Mel Schlesinger

3. How do Consumers Become Engaged With
the Use of Telemedicine / Health?
 From their Physicians office or healthcare clinic
 From a local or regional hospital
 From a provider, such as TelaDoc, E-Telemed, MD Live
 Via their health insurance carrier
 You, their Health Insurance Advisor
To Individuals and their families
To any size businesses on an employer-pay-all or voluntary
basis
Associations
Not-for-profits
Mel Schlesinger

4. 2 Models of Advisor Delivered Telemedicine / Health…
a) No charge to the consumer/ patient until the telemedicine
connection is made, then pays a copayment (i.e. $30-$50)
per electronic consultation. Similar to a standard physical
office visit copay.
b) Consumer/patient pays a recurring monthly fee (credit
card, list bill or employer pay all). Typical fees range from
$9.95 for telemedicine only to $29.95 pmpm for a bundled
telehealth program for an entire family with unlimited
consults per month.
 Telemedicine / Telehealth is in 48 states and The D.C. (due
to state laws telemedicine is not available in Idaho & Arkansas)
Mel Schlesinger

5. Telemedicine: Improving Access, Decreasing Costs
 Telehealth improves patients' access to
doctors when they might otherwise face
delays or be unable to reach a physician. It
can allow patients to interact with both
primary care doctors and specialists over
live video, limiting the need for an office
visit.
 A 2012 study from Johns Hopkins University
concluded that telemedicine didn't just
produce equal clinical outcomes to in-
hospital care but, in some cases, produced
better outcomes.
 Costs are much lower with telehealth,
because it removes the need for
transportation…
http://www.ncpa.org/sub/dpd/index.php?Article_ID=253
26
Mel Schlesinger

6. When is Telemedicine appropriate?
…and many other additional conditions
Mel Schlesinger

7. When is Telemedicine Not Appropriate?
The Telemedicine Physician will direct the
patient to call 911 or go to nearest ER for
Broken Bones
Cuts
Burns
Heart Attack
Accidents
Mel Schlesinger

8. How Does it Work?
Mel Schlesinger

9. Two Individuals
Mel Schlesinger

10. Telehealth Versus Status Quo
John Jane
Mel Schlesinger

11. Telehealth Versus Status Quo
John Jane
Mel Schlesinger

12. Average Telemedicine Savings (graphic)

13. Projected Growth of
TeleMedicine/Health
Mel Schlesinger

14. Telemedicine/Health Growth Projections
Forbes contributor Bruce Japsen
recently interviewed an analyst at IHS,
who predicts that the U.S. telehealth market will
grow to $1.9 billion in 2018 from $240 million
today, an annual growth rate of 56 percent. This
is explosive…
Mel Schlesinger

15. Video consultations to triple by 2015
 In 2014, there will be approximately 5.7 million
telemedicine consultations, which is
expected to jump to more than 16 million in
2015. Furthermore, by 2018, the number of
video consultations is projected to surpass
130 million.
http://www.beckershospitalreview.com/healthcare-information-
technology/video- consultations-to-triple-by-2015.html
Mel Schlesinger

16. Wait Times for Physician Office Visits
Mel Schlesinger

17. Fewer Physicians
81% of physicians describe
themselves as either
overextended or at full
capacity, up from 75% in
2012 and 76% in 2008. Only
19% say they have time to
see more patients.
44% of physicians plan to
take one or more steps that
would reduce patient
access to their services, such
as cutting back on patients
seen, retiring, working part-
time, closing their practice
to new patients…
39% of physicians indicate
they will accelerate their
retirement plans due to
changes in the healthcare
system.
2008 2012 2014
0-10 7.4% 19.5% 22.8%
11-20 31.7% 39.8% 35.7%
21-30 41.2% 26.8% 24.6%
31-40 13.6% 8.1% 11.4%
41-50 3.7% 2.6% 2.8%
51-60 0.99% 0.8% 1.4%
61+ 1.23% 2.4% 1.3%
Avg. 23.4% 20.1% 19.5%
On average, how many patients
do you see per day (include both
office and hospital encounters)?

18. With 30 Million More People Coming Into
the Healthcare System due to ACA
 Consider these sobering figures:
Even before health reform, a multitude
of studies warned that the U.S. would
face a shortage of primary care
providers as large as 45,000 by 2025
The shortage will further increase as a
result of the insurance expansion which
will go into effect in 2014. With 30 million
newly-insured individuals seeking care,
at least 52,000 new providers will be
needed by 2025.
Mel Schlesinger

19. The Impact of Cost
Mel Schlesinger

20. Cost Still a Barrier Between Americans and Medical Care
 In the U.S., 33% have put
off medical treatment
because of cost
 More with private
insurance put off
treatment in 2014 than
2013
Mel Schlesinger

21. Cost Still a Barrier Between Americans and Medical Care
 The percentage of Americans
with private health insurance
who report putting off medical
treatment because of cost has
increased from 25% in 2013 to
34% in 2014.
http://www.gallup.com/poll/179774/cost-barrier-americans-medical-care.aspx
Mel Schlesinger

22. Skipping Care…
 Nearly 30% of privately
insured, working-age
Americans with deductibles of
at least 5% of their income
had a medical problem but
didn't go to the doctor, the
Commonwealth Fund found.
 43% of those with private
insurance said their
deductible was either difficult
or impossible to afford.
Mel Schlesinger

23. Fear of Cost and Avoidance (10/28/14)
http://www.sciohealthanalytics.com/harrispoll
Mel Schlesinger

24. Health Advocacy
Reducing Out of Pocket Liability
Mel Schlesinger

25. Advocacy (1) The process of actively supporting the cause
of, speaking or writing in favor of, or defending or
interceding on behalf of a person (case advocacy) or
group (class advocacy). Advocacy may include providing
information and tools for self-empowerment in patients’
health and social care, and helping them obtain needed
services.
(2) Action to assure the best possible services for or
intervention in the service system on behalf of an individual
or group.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights
reserved.
Mel Schlesinger

26. Advocacy Models
Medical Bill Saver
Technical Assistance
Health Coaching
Mel Schlesinger

27. Technical Support
Helps identify the right physicians and hospitals
Identifies treatment options
Helps with second opinions
Assist in decision-making
Mel Schlesinger

28. Medical Bill Advocacy
 Help patients understand the bills
 Identifies billing errors
 Negotiates the amount owed by the patient with providers
Average Bill Savings = 50% to 60%
Mel Schlesinger

29. Impact of Higher Deductibles
Mel Schlesinger

31. Mel Schlesinger

32. Average 2015 Deductibles for ACA Plans
2/3 of Americans
Enrolled in the
Silver Plans
Individual
Coverage
Family
Coverage
Bronze $5,181 $10,545
Silver $2,927 $6,010
Gold $1,198 $2,626
Platinum $243 $489
Source; March 2015, InsuranceNewsNet Magazine
Mel Schlesinger

33. Skipping Care…
43% of those with
private insurance
said their
deductible was
either difficult or
impossible to
afford.
Mel Schlesinger

34. American Saving Statistics
 28% - Have zero savings
 20% - Cannot pay 3 months of living expenses
 43% - Have just enough to cover 3 months of living expenses
 Bankrate.com – 2012
 Average Median Savings = ZERO (foxbusiness.com 2014 – Kate Rogers)
 56% of Adults with Children under 18 have less than $800 in savings
 Statisticbrain.com – using 2014 Federal Reserve and Census data
Mel Schlesinger

35. Medical Bills Vs Insurance Company EOB
Narrow Networks = Unexpected Charges
Challenges
Mel Schlesinger

36. Better Than Gap Insurance
Mel Schlesinger

37. GAP Vs Telemedicine+Bill Saver
$3500 GAP Insurance
 Cost: $101.84 monthly
 Lacks Transparency
 Little or no help for urgent care
 Lower benefit for outpatient
treatment
Telemedicine+Bill Saver
 $19.95 monthly
 Creates transparency
 No-cost Alternative to urgent care
 No distinction between in and
outpatient care
 Creates employee engagement
Mel Schlesinger

38. Making the Business Case for Telemedicine /
Health Advocacy
Mel Schlesinger

39. Good medicine for small businesses
 A case study involving a 150-person trucking company that faced a
17% increase in its health insurance premium.
 To ease the pain, the company considered switching to a plan with a
higher deductible. That would have saved $150,000 a year in premiums;
it also would have aggravated their employees who would be forced
to pay a bigger portion of their medical bills from their own pockets.
 Enter telemedicine. In 2012 the company paid $120,000 in claims for
“non-emergent” doctor visits (the sniffles and such), including expensive
trips to the ER. According to a recent study by AmeriDoc the firm would
save roughly $65,000 in claims. Cost of the telemedicine plan: $24,000.
 As for the employees, they’d get to keep their health benefits while not
wasting productive hours schlepping to a doctor’s office or an ER.
http://www.forbes.com/sites/brettnelson/2013/03/28/a-ray-of-hope-for-affordable-
convenient-quality-health-care/

40. Telemedicine Reduces Employees Group Health
Claims
 Telehealth’s savings in claim costs range from $300 per
year for a single employee or more than $1,000 per year
for a family of four.
 Rent-A-Center, a national chain of rent-to-own stores
with more than 12,300 employees, has benefited directly
from telemedicine. Of the total number of employees,
6906 participated, saving the company more than $1.2
million over the course of a year.
http://www.theihcc.com/en/communities/health_access_alternatives/telehealth-emerges-in-a-
consumer-driven-marketplac_huo61ym9.html

41. Telemedicine – A Less Expensive Altermative
 In a survey of 1,000 U.S. employers, 37 percent said that by 2015
they expect to offer their employees telemedicine consultations
as a low-cost alternative to emergency room or physician office
visits for nonemergency health issues, according to Towers.
 Another 34 percent are considering offering telemedicine for
2016 or 2017.
http://www.clinical-innovation.com/topics/mobile-telehealth/telemedicine-could-yield-6b-year-savings
Mel Schlesinger

42. Telemedicine Reduces Employee
Absenteeism Cost
 According to Absenteeism: The Bottom-Line Killer, a publication from
workforce Solution Company Circadian, unscheduled absenteeism
costs roughly $3,600 per year for each hourly worker and $2,650 each
year for salaried employees.
 When factoring in the costs saved by redirecting care and keeping the
employee at work, we calculate each call to a telehealth doctor will
save an employer close to $240.
 Americans (employee, spouse & dependents) Make Nearly Four Medical
Visits a Year on Average.
http://www.cdc.gov/nchs/pressroom/08newsreleases/visitstodoctor.htm
 The numbers are staggering.
http://www.theihcc.com/en/communities/health_access_alternatives/telehealth-emerges-in-a-
consumer-driven-marketplac_huo61ym9.html

43. Millennials
 Younger Patients Will Expect Telehealth options
 …the young set of patients who have grown up
with Skype, instant messaging services and social
media are more than happy to embrace the
telemed trends as the future of their healthcare.
In fact, many of them would probably prefer it:
the upcoming generation of adult patients in the
U.S. will be more “plugged in” than ever before…
 60% of millennials support the use of telehealth
options
 71% of millennials would like their doctor to use a
mobile app
http://healthworkscollective.com/abby-norman/293436/top-5-telemed-trends-2015

44. Tech-Savvy Seniors Want Online Options to
Access Care from Home, Accenture Survey
Shows
http://m.newsroom.accenture.com/news/tech-savvy-
seniors-want-online-options-to-access-care-from-
home-accenture-survey-shows.htm

45. Telemedicine improves rural access to healthcare.
 Up to 25 percent of U.S. residents reside in
rural areas.
 Compared with urban populations, rural
residents generally have higher poverty rates,
have a larger elderly population, tend to be
in poorer health, and have higher uninsured
rates than urban areas.
 Correspondingly, rural areas often have fewer
physician practices, hospitals, and other
health delivery resources.
 These socioeconomic and health care
challenges place some rural populations at a
disadvantage for receiving safe, timely,
effective, equitable, and patient-centered
care…
U.S. Department of Health and Human Services
Health Information Technology
http://www.hrsa.gov/healthit/toolbox/RuralH
ealthITtoolbox/Introduction/ruralhealth.html

46. Telemedicine improves rural access to healthcare.
 Telemedicine has become an
important part of the strategy to
improve health service delivery in
medically underserved areas
 in both rural and urban settings. It
enables remote interactions among
providers and between providers and
patients.
 Telemedicine has the potential to
improve rural pediatric care by
increasing access to pediatric
specialists and services.
U.S. Department of Health and Human Services
Health Information Technology
http://www.hrsa.gov/healthit/toolbox/RuralH
ealthITtoolbox/Introduction/ruralhealth.html
Mel Schlesinger

47. Telehealth Programs Allow More Rural Seniors to Live
at Home
 Revolutionary telehealth approaches across the United States
are helping senior citizens continue to live independently in
their own homes.
 In five Midwest states, a research project underway uses
advanced telehealth capabilities and motion sensors to track
and electronically report residents’ daily vitals and changes in
trends.
 In Kansas, integrating telehealth with home nursing care
and social service supports has decreased hospital and
nursing home admissions.
In New York State, short-term home telehealth intervention
is helping seniors with chronic diseases manage flare-ups
that jeopardize their ability to remain at home.
http://www.raconline.org/rural-monitor/telehealth-programs-rural-seniors/

48. Conclusion / Questions / Answers
Thank You!!!
For follow up questions
Mel Schlesinger
336-310-6564
Email: mel@melschlesinger.com
Mel Schlesinger