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UnitedHealth Group (UNH) is offering the widest health insurance coverage yet of doctor visits via telemedicine, offering access to three different medical care provider networks that connect physicians and patients via smart phone, tablet or computer.

UnitedHealth, the nation’s largest health insurer says 20 million Americans could access telemedicine and receive coverage for it by next year. The announcement raises the bar on covering “virtual” medical care, which gives patients access to a network of providers. Already, Cigna CI CI), Aetna AET (AET) and other health plans have varying degrees of access for individual customers and employers to telehealth offering more services than ever to a public demanding quick access to digital health. UnitedHealth’s rivals are rapidly expanding their coverage of telemedicine, too.

But UnitedHealth, because of its size, is shaking up the market. Initially, UnitedHealth’s UnitedHealthcare subsidiary is rolling out “virtual care doctor’s visits” to nearly 1 million health plan members in self-funded plans that will have access to these providers by the end of May. By Jan. 1, 2016, 20 million members in UnitedHealth’s fully insured plans will have access to the network.

“By reimbursing health care providers for delivering care in this new and innovative way, we are making it easier and more affordable for patients to access the treatments they need, while enabling health professionals to deliver high-quality and convenient care,” Dr. Richard Migliori, executive vice president and chief medical officer, UnitedHealth Group said in a statement from the Armada Specialty Pharmacy Summit where he is giving a keynote address this week.

Cigna began last year to provide access to internists, family physicians and pediatricians in a deal with telehealth provider MDLive. A Cigna spokesman said the insurer has been offering “reimbursable virtual house calls” nationally since 2007 with the program currently available to more than 80 percent of its clients.

And Aetna has had a relationship with Teladoc since 2011 and the relationship has grown to more than 160 health plan sponsors. What’s more, Aetna  is “working with Teladoc to expand to behavioral health providers,” an Aetna spokeswoman said.

No matter how widely available these health plans and others make telehealth, it’s clear that virtual medicine is entering a new era. In the past, insurers and government health plans like Medicare and Medicaid have dabbled with telemedicine via pilot projects and test markets.

But trends in coverage under the Affordable Care Act and the private sector are pushing away from fee-for-service medicine that emphasizes volume and leads to unnecessary tests and procedures to value-based care that manages populations of patients. In the value-based approach, providers are paid to make sure patients get the right care, in the right place and at the right time.

UnitedHealth members will have access to Doctor On Demand, which offers video access to an array of providers including physicians, psychologists and lactation consultants; NowClinic, a subsidiary of UnitedHealth’s Optum business, which has connections with health professionals in 45 states; and American Well, which has access to board-certified health professionals across the country.

“This groundbreaking telehealth initiative brings virtual care to more people than ever before, representing a broad step forward for using technology to improve care and expand access for non-emergency medical issues,” Migliori said.

In UnitedHealth’s case, the cost of the virtual visit is $50 but can be less depending on the employer or what the self-funded client is willing to offer the health plan member. The cost could be less with a co-payment or other co-insurance depending on the plan.

When members use UnitedHealth’s network the can expect real-time video and audio access to physicians and other providers who can diagnosis, order prescriptions and evaluate what the insurer described as “minor medical needs” like sinus and bladder infections, allergies and other conditions.

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Autor(en)/Author(s): Bruce Japsen

Quelle/Source: Forbes, 05.05.2015

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