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The Pros and Cons of Telemedicine

The implementation of telemedicine has risen immensely over the last few months, as social distancing requirements were put into place. Telemedicine can be a great way to communicate with your doctor in the safety of your own home. Virtual visits can be used to detect symptoms of COVID-19, fevers, rashes, cold and flu symptoms, aches and pains, minor musculoskeletal injuries, small infections, and UTIs. While telemedicine can be an effective way to treat patients, there are pros and cons to consider.

The pros associated with telemedicine include:

  • Convenience. According to a study, 74% of patients prefer easy access to healthcare services over in-person appointments. Not only does this provide convenience for all patients, but it also helps those who live in remote locations have access to proper patient care. 
  • Cost-effective options. These services reduce healthcare service costs significantly. It helps to attract new patients, reduce no-shows, and reduce overhead for physicians who decide to utilize telemedicine.
  • Patients minimize unnecessary visits. As a patient, it can be a waste of time and money to go to the doctor or ER for minor medical consultations. If your symptoms do not require an in-person visit, opt for a telemedicine appointment instead! 
  • Telemedicine can lead to improved healthcare quality. When it is easier for providers to engage with patients, and remotely track their health with monitoring systems, they can work to identify problems as they develop. 

Now, let’s look at some of the cons linked to telemedicine:

  • Sometimes in-person visits are necessary to diagnose. Physical exams are impossible over the phone, which may be necessary for the diagnosis or treatment of a patient. For example, the COVID-19 test requires a nose and throat swab, to diagnose, so you must go to the doctor physically.
  • Security concerns. With the relaxation of telemedicine requirements due to the global pandemic, security concerns may arise. Cybercriminals can hack into telemedicine systems to steal personal healthcare information. 
  • You may not know the doctor providing your care. Utilizing virtual care services may mean you have a stranger on the other end of the call. These doctors will likely be unfamiliar with you and your medical history, and it may affect the level of care they can provide.
  • Training and equipment can be expensive. Reorganizing IT staff to train and create effective equipment costs both time and money. To ensure ROI from implementing telemedicine, staff, physicians, and medical staff needed to be trained properly. 

Although there are a few things to work out within the telemedicine technology, as you work to implement telemedicine into your benefit programs, the benefits of telemedicine can make a large impact. At SBMA, we believe in the power of telemedicine. That’s why we offer free telemedicine programs in all of our benefit programs. Learn more here.

When is it safe to go back to a doctor’s office?

When is it safe to go back to a doctor's office?

Hospitals and doctor’s offices seem like the worst place to be during a pandemic. Many medical offices, hospitals, and surgeons canceled non-emergency procedures to accommodate the influx of coronavirus cases. Knowing that the numbers of cases are still high, it may be anxiety-inducing to go back to the doctor for your normal check-up. Businesses have started to reopen, and doctors have started to schedule more non-emergency procedures. Is it safe to go back to the doctor’s office? 

The pressure for hospitals and doctors offices to re-open is great even while patients are wary to return. The financial implications of reopening serve as incentives for some medical offices to reopen, as the pandemic has caused the hospital industry to lose about $50 billion per month. Elective procedures are the lifeblood of hospitals, financially;  without them, hospitals have struggled. 

While doctor’s offices are seen as a place of healing and safety, in the current climate it may be difficult to choose to go back.  Telemedicine offers a solution for those who are worried about seeing their doctor in person. Telemedicine offers a solution for non-emergency care front eh safety and convenience of your own home while still ensuring that your symptoms are reviewed and a medical professional is monitoring your case. 

Health care providers are taking care to keep their patients safe. These precautions include: 

  • COVID-19 screening questionnaires
  • No-touch thermometer temperature check for employees and patients. 
  • Required face masks
  • Implementing social distancing measures in populated areas
  • Employees are tested regularly
  • Patients may be tested a few days before their procedure

While health care providers are covering a lot of bases, there are a few things you can do to keep yourself as safe as possible. Including:

  • Take your temperature before you go to your appointment
  • Wash your hands before you leave the house and sanitize regularly
  • Wear a mask and gloves if you feel it’s necessary
  • Avoid touching your face, especially areas like your nose, eyes, and mouth
  • Show up on time, not before to avoid overcrowding in the waiting room
  • Try to stay away from touching surfaces
  • Practice proper social distancing measures

While you begin to navigate returning to in-person patient care, consider your options and take the proper precautions. 

If you can utilize Virtual Health/ telemedicine, now is the time to use this service.  While telemedicine can’t replace all in-person appointments, it can replace regular checkups, virus check-ins, cold and flu-like symptoms and rashes, and many other non-life-threatening cases.  For those who still feel the need to go into the MD’s office: if you take the proper precautions when you are in-person you can navigate this new normal and stay safe!

return to the doctor's office

Are You Liable for Shared Responsibility Payments?

are you liable for shared responsibility payments?

With all the recent changes to employment due to the global pandemic, navigating ACA compliance can be challenging. ACA noncompliance may lead to shared responsibility payments. Businesses with 50 or more full-time employees must offer affordable, minimum essential health coverage. 

How can your business avoid tax penalties from the IRS? 

The first step to avoid potential shared responsibility payments is to make sure your business stays compliant with the ACA shared responsibility requirement. While this may seem simple, there are few distinctions to be aware of, including determining full-time employment status and full-time equivalents, and identifying the minimum value requirements. 

If employers do not cover at least 95% of full-time employees and their dependents, the employer will be subject to a shared responsibility payment. 

If a full-time employee receives a premium tax credit because they were not offered coverage, the coverage was not affordable, or the minimum value was not provided, the employer may also be subject to a shared responsibility payment. 

Once you have identified how to stay compliant with the ACA shared responsibility requirements, ensure your reporting is accurate and timely. 

Applicable Large Employers (employers with 50 or more employees) are required to file information returns with the IRS, Forms 1094-C and 1095-C. These forms will inform the IRS of the employers that owe shared responsibility payments.

To mitigate the risk of receiving a letter from the IRS for shared responsibility payments, employers should carefully review and complete the forms above. 

If you do receive a shared responsibility payment letter from the IRS, the employer has 30 days to respond. If you do need more time to gather your information, the IRS may be able to extend the 30 days deadline. Either way be sure to respond or ask for an extension as quickly as possible.

If you are required to pay a shared responsibility payment be sure to consult a lawyer to ensure your reporting is accurate. At SBMA, we want to ensure you remain compliant with all ACA requirements. If you receive a letter from the IRS in 1094/1095 filing that we completed, we will refile your forms, free of charge. 

Contact us today to learn more.

shared responsbility payments

Can a Doctor Really Diagnose Over Zoom?

Is zooming your doctor the new normal?

Imagine you’re in quarantine, beginning to feel early symptoms that align with Coronavirus, yet to keep others safe you feel you need to stay home. The symptoms begin to worsen, but you still don’t want to risk others safety by leaving the house. How can you ensure you will be okay without leaving the house? Telehealth services might be your saving grace. This begs the question, can a doctor really diagnose over Zoom?

The American Medical Association is working to maximize telemedicine service options in order to revolutionize healthcare– especially because COVID-19 is highly contagious. Not only does telemedicine help keep potential Coronavirus carriers quarantined, but it also helps those who have had non-urgent medical care postponed due to the pandemic. 

These services can be extremely beneficial for those who still need to go to work, or those who have to take care of their children at home. With children home from school, it can be more challenging to leave them home with a sitter, so what does that mean if you have to go to the doctor? Well, you can just hop on a Zoom call during their nap and get the same results as going to the doctor!

So how exactly does telemedicine work?

Drs. Francavilla Brown and Boyd told AMA that telemedicine “is easier than people think it is to incorporate into a practice.” 

With technological advancements typically come progress and challenges. Physicians who have tried implementing telemedicine have identified these challenges, and have come up with a few solutions. 

One challenge is patients may not have a good signal to support their doctor’s visit. Trouble with a weak signal may make the appointment longer, or impossible for someone who really needs it. Another challenge physicians have identified is booking appointments to be a televisit for doctor’s offices. The patient must call into the office to ensure their appointment is virtual. 

While telehealth services may not be the best option for detecting major issues, it has been great for reassessing and monitoring patients who have known problems. It can also be used to adjust medications, answer questions, and share information. Patients in areas where medical resources are limited also benefit greatly from these services. 

These services also help people avoid unnecessary hospital visits, which helps to give advice at a distance, save time, and reduce costs for both patients and doctors. Not only will it help avoid hospital visits when they aren’t necessary, but it will also give patients in the hospital the ability to discharge sooner by monitoring their vitals with telemedicine.

Zooming your doctor may begin to become the new normal in a post-COVID world. At SBMA, we offer telemedicine services at competitive prices. Contact us to learn more about how our benefit plans with telemedicine services today!

Can a doctor really diagnose over zoom?

Virtual Care and the Telemedicine Revolution

During this time of uncertainty, there has been an increase in consumer demand for virtual healthcare services, which has put added pressure on providers and payers to expand delivery options for on-demand health services.

A survey from Accenture, which included 1,501 consumers who answered questions online, found that most people are willing to utilize virtual healthcare services. For the 20% of respondents who had received care virtually, the reasons they cited most often for seeking virtual care are:

  • Greater convenience than traditional in-person healthcare services (37%)
  • Familiarity using technology to manage their health (34%)
  • Curiosity to try virtual health (34%)

Consumers said they would be more likely to “try virtual” if encouraged by a physician or familiar healthcare provider.
According to the research, today’s consumers are demanding a combination of in-person and virtual health services. More than 75% of those surveyed said they would be interested in receiving healthcare virtually some or most of the time.

What is Virtual Health?

Virtual health includes health care innovations like virtual appointment kiosks and portals, remote consultations, and electronic personal health records. These components work together to allow for easier access to care, such as virtual wellness coaching, remote monitoring, video visits, and online health chats, among several other benefits that we will examine more closely below.
Virtual health combines clinical care and professional collaboration through telemedicine, telehealth, and collaboration at-a-distance to connect clinicians, patients, care teams, and health professionals to provide health services, support patient self-management, and coordinate care across the care continuum.
Specific to physician-patient encounters, virtual health enables live and asynchronous clinical interactions, clinical practice, and patient management supported by a wide range of communication, collaboration, and cognitive computing technologies along with digital devices and data.


Benefits of Virtual Health and Telemedicine

As you can see, there are many benefits of offering Virtual Health. For patients and medical practices, the use of telemedicine technology allows patients to receive follow up care and chronic illness management from their own home on the devices they already own and use. This follow-up care is especially crucial for those who are homebound or have difficulty arranging travel.
For healthier patients, it reduces travel time and costs and requires less time away from work. As an added benefit, patients do not have exposure to other potentially contagious patients. In short, telemedicine removes many of the barriers preventing people from actively managing their health.

Here are the main benefits for most patients:

Improved Access – Not only does telemedicine improve access to patients, but it also allows physicians and health facilities to expand their reach beyond their own offices. Telemedicine has a unique capacity to increase service to millions of new patients.

Cost Efficiencies – Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.

Improved Quality – Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations.

Virtual Health Care technology is excellent for providers as well. It can help extend clinical services to reach more patients efficiently and profitably. It helps improve health outcomes by increasing patient compliance with follow up and chronic illness management. Virtual Health Care strengthens patient relationships without putting additional strain on the medical staff.
There are significant benefits to medical practice, as well. By utilizing virtual health, your practice can expand access to care. It improves clinical workflows by helping your staff capture each patient’s reason for the call or visit quickly, prioritize care delivery, suggest the best treatment guidelines, and identify additional information resources. Virtual health care can also support communication along the care continuum.

What does this mean for my practice?

Technology is providing new methods to assist your clients by responding to the need for better communication. It’s also creating a competitive landscape the medical field has never seen before. Embracing this new trend will enable you to maintain your patients for years to come.

Contact SBMA for more information on employee benefits packages that include virtual health services!

What Exactly is Telemedicine?

Healthcare providers have been offering remote services for years, which have allowed patients to receive healthcare from the comfort of their own homes. Before the recent advancements in technology, these remote services were done over landline phones. Now patients can see their doctors at their office using various online platforms, including Zoom and Skype. So what exactly does telemedicine entail? 

Using telemedicine, you can discuss symptoms, medical issues, receive a diagnosis, learn treatment options, and get prescriptions. There are a few common types of telemedicine which include:

  • Interactive Medicine: This involved a physician and patient communicating in real-time. 
  • Remote Patient Monitoring: This gives caregivers the ability to monitor specific patients who have medical equipment that collects information like blood pressure, blood sugar levels, and more.
  • Store and Forward: This type of telemedicine allows providers to share their patient’s information with other healthcare specialists and professionals.

While they sound the same, there are a few critical differences between telemedicine and telehealth. Telemedicine, as stated by the World Health Organization, is “healing from a distance.” You receive treatment without an appointment or visiting the office. Telehealth uses electronic information to support long-distance clinical healthcare, education, and administrative activities. It improves patient care and physician education rather than providing a service. It involves scheduling appointments, medical education continuation, and training for physicians.

When should you use telemedicine? Telemedicine is not for emergencies. Anything that requires urgent, primary care, you should go to a doctor in-person. However, telemedicine is for straight-forward questions and issues, and any follow-up consults. It also can be helpful with psychotherapy and teledermatology. Some examples of straight-forward issues include cold and flu symptoms, insect bites, diarrhea, pink eye, and sore throats.

Telemedicine has advanced our current health care options by offering several new benefits. It is making healthcare accessible for more patients, whether they live in a remote location, have a packed schedule, or any other number of other reasons. 

Telemedicine is also much more financially accessible. A recent study found that the average telemedicine visit is around $79, whereas an average doctor’s appointment is $149, and a trip to the emergency room costs, on average, $1,734. As telemedicine continues to grow, health insurance providers are offerings coverage for telemedicine visits. Some states even require that health insurance plans reimburse patients for telemedicine visits. 

Telemedicine offers a more accessible opportunity for healthcare and changing the way we visit the doctor. At SBMA we offer the most competitive limited benefit plans in the industry, including virtual health options! Check out our services for more information!

Health Insurance Options for Coronavirus Job Loss

As COVID-19 continues to impact our daily lives, unemployment has reached a record high, jumping to 14.7% as of April 2020. There are many things to consider when assessing these new statistics and, as an employer or an employee, it’s important to ask yourself this question: What health insurance options are there for those that have experienced job loss due to Coronavirus?

If you’ve lost your job due to Coronavirus or have experienced a reduction in hours, here’s what you can do:

If you’ve lost your health plan through your job you may qualify for a Special Enrollment Period. If you have lost your coverage within the past 60 days, or you expect to lose coverage in the next 60 days, you are also eligible for a Special Enrollment Period. 

If you have experienced a reduction of hours and are part of a Marketplace plan, you should update your application to report any household income changes within 30 days. This may lead to more savings than you’re getting now.

If you have experienced a furlough, depending on the status of your coverage, you might be eligible for a Special Enrollment Period. You might also qualify for a premium tax credit to assist your Marketplace coverage payment.

For people with COBRA continuation coverage, you may be able to qualify for the Special Enrollment Period. Based on your pre-COBRA coverage, you have 60 days to enroll in Marketplace coverage. You may also qualify for premium tax credits, only if you end your COBRA continuation coverage. 

If you have lost your job, but your company did not offer coverage, you typically do not qualify for a Special Enrollment Period. Job loss on its own does not make you eligible for a Special Enrollment Period.

If you are unable to pay your insurance premiums due to Coronavirus there are some things to consider: First, check with your insurance providers to see about extensions. Usually, there is a grace period determined by state law. If you receive financial assistance with your premiums, there is a three-month grace period where your plan cannot be terminated for failure to pay premiums. 

If you know that you qualified for a Special Enrollment Period, but missed the deadline due to Coronavirus impact, there is a chance you can be eligible for another Special Enrollment Period. 

As employers continue to understand how to effectively run their businesses throughout Coronavirus, we want to help you understand how to remain covered and safe. Here is a list of our COVID-19 resources that may be helpful as you work to understand what’s next for you and your company. 

How Coronavirus is Affecting Healthcare Costs

Coronavirus has disrupted quite a few industries over the last few months. One of the industries that it will continue to affect for the foreseeable future is the healthcare system. As it continues to spread, and we continue to see the effects of coronavirus, insurance programs will likely see a rise in health care costs. Here is an overview of how we think coronavirus could affect health care costs:

The first place we will likely see a rise in healthcare costs is with testing and treatment. As the number of coronavirus cases is still unknown and potentially growing, public health will be vital to limiting and eliminating the spread of coronavirus. There are mixed messages on whether or not we have reached the peak number of cases in the U.S, and some say that there may be another spike in cases shortly if social distancing is relaxed. 

The cure for coronavirus is still unknown, but the usage of current treatments are a way to support those who are infected. Once an effective treatment is established, there will likely be a reduction of strain on healthcare systems. Still, additional costs of implementing new drug treatments will cause the overall cost of care to increase along with a new vaccine treatment as an added cost in the near future. 

Around 15% of people infected with coronavirus require some kind of hospitalization, which typically includes needing ventilation. Costs associated with these procedures can be extremely expensive. Ventilation treatments can cost anywhere from $34,223 to $88,1114, depending on how long a person is on the ventilator. 

Many healthcare providers are concerned about the possibility of seeing an influx in people using healthcare services after stay-at-home orders lift. It is likely that the low demand for healthcare now will cause a delayed demand that could be overwhelming for providers and insurance companies later down the road. This sudden influx could quickly drain hospital resources if they are not adequately prepared. In some parts of the country, hospitals could not have enough beds for the number of patients needing care.

Hospitals have already begun canceling elective procedures. Though they are considered elective and therefore not urgent, these procedures almost always improve the patient’s daily life and prevent early death. These delayed procedures will likely be scheduled for next year, which would raise overall healthcare costs for 2021. Foregoing these procedures could also cause health outcomes to decline, as well as higher spending for the individual later due to complications. 

Medicare

Because the older populations are at high risk for contracting COVID-19 and potentially having complications related to coronavirus, the Medicare program could be affected. An increase in Medicare spending could potentially spill-over into the beneficiaries’ out-of-pocket spending in years to come. The out-of-pocket expenses will show up as an increase in premiums, deductibles, and other cost-sharing programs. 

Another consideration that may affect Medicare spending is telehealth services. Under the CARES Act restrictions on telehealth services, which could cause a decline in doctor’s office visits and the costs associated with holding in-person appointments.

Medicaid

Medicaid programs will also likely be affected by COVID-19. The costs of the program will likely increase as unemployment increases, and people are losing coverage provided by their jobs. Medicaid spending and enrollment increases in times of economic downturn. As more people enroll and the costs dealing with testing and treatment increase, the pressure on Medicaid costs will also increase.

As we continue to understand the effects of coronavirus, there are many implications to consider. Contact us to get the right coverage for you and your company.

The Telehealth Revolution and Coronavirus

The demand for telehealth services has skyrocketed in the wake of the coronavirus pandemic. Still, an increase in consumer demand over the past several years can guarantee that telehealth options are here to stay. 

Public health officials are encouraging consumers to utilize contact-less telehealth services to stay safe and slow the spread of COVID-19. Not only does this form of healthcare keep the user safe from germs, but it also can help give doctors quick access to patients who need care urgently, but may be located in other parts of the country. While there is a lot to understand when it comes to telehealth services, here are the things we consider to be the most important:

How are people responding to telehealth services?

According to a survey from Accenture, 74% of those surveyed were happy with their telehealth experience. About 75% of people said they would use telehealth services to access healthcare after hours. Two-thirds said they would use this service for follow-up appointments rather than seeing a healthcare professional in person. 

So, how does telehealth work?

Email, video conferencing, and video chat services are used to receive care from the comfort of your own home. The healthcare professionals responding to consumers either respond in real-time or giving consumers a place to find their answer.

The costs associated with telehealth services are dependant on the insurance plan coverage. Programs like Medicare cover telehealth services. Consumers can also pay out-of-pocket for their telehealth services. These services can cost anywhere from $50 to $80, or a potential annual membership fee.

As far as security goes, patient privacy is protected if the providers are operating in good faith. But if these services use avenues, like Zoom or Skype, the security may be a little riskier. At SBMA, we offer 24/7 access to doctors with no cost to you, as well as behavioral health services with a $50 copay. 

Telehealth services also give doctors the ability to send in a prescription to a pharmacy. Our telehealth services cover generic physical and behavioral prescriptions with a $10 or $25 copay.

While telehealth services cannot diagnose or treat coronavirus, they can offer quarantine and self-care tips to implement while you are home. If you are unsure whether or not to go to the hospital, you can use telehealth services to help decide whether or not you need to. 

For more information on telehealth services and how you can offer them or receive them, contact us!

Medicaid Coverage Can Save Lives!

Having coverage is extremely important in ensuring your health and wellbeing especially during today’s environment. While some states believe that it’s too late to expand Medicaid coverage, it could help those unemployed greatly. Over the last few months, all but 15 states have participated in the expansion of Medicaid. This coverage can help save lives.

The Kaiser Family Foundation found that the expansion of Medicaid has resulted in a near 30% drop in cancer-related deaths. Similarly, the National Bureau of Economic Research found that if all 50 states implemented the expansion of Medicaid, 15,6000 deaths could have been avoided.

Over 4 million people who are currently uninsured would gain coverage from the expansion of Medicaid. In states that have already implemented expansion, those who have lost their jobs, or lost a significant amount of income, will be able to gain coverage. Not only does this expansion aid in today’s crisis, but it also increases access to care, improves financial security, and Medicaid coverage can save lives in a normal circumstance. 

Those without coverage, today, might be hesitant to seek testing and treatment of COVID-19, with the fear that they cannot afford it. This endangers the individual along with others who they may transfer the virus to. Under the changes to the ACA, Medicaid covers testing and treatment for COVID-19, as well as treatment for other health conditions.

States that have not implemented the expansion of Medicaid, always have the option to expand. Once they send in the information regarding the implementation of Medicaid coverage, a state can ask CMS to approve of retroactive coverage. This coverage can allow those who apply for Medicaid to receive coverage up to 3 months prior.

If states submit their expansion plans before June 30, their expansion will be retroactive to April 1, so Medicaid can pay for any medical costs incurred starting on April 1. This also applies to those who do not apply for Medicaid until July. Retroactive coverage also helps the financial stability of health care providers through the reduction of uncompensated care costs. 

So, there you have it, Medicaid coverage can save lives, by helping to prevent and treat those who may be unsure if they can afford proper healthcare. At SBMA, we offer competitive Medicare packages for everyone. Learn more about our insurance offerings on our site! Contact us for information regarding your plan, and what you need going forward.