UnitedHealthcare has been offering video visits through Doctor on Demand and American Well for nearly six months now, since the start of the year. At a panel at the American Telemedicine Association conference in Minneapolis, representatives from all three companies reported on their experiences with the partnership and also shared some thoughts about the future of telemedicine.

Karen Scott, senior director of marketing, product and innovation at UnitedHealthcare shared some early data about the insurer’s experience with video visits. So far they’re expecting 20 million users by the end of the year. 

The majority of video visits on the platform have been for respiratory issues, she said — those accounted for more than 50 percent of visits, while no other single category accounted for more than 10 percent. The average video visit user was a 31-year-old female.

Michelle Lobe, VP of network strategy and innovation at United, said that 90 percent of the employers they cover are interested in offering the capability, but most are concerned about low utilization and adoption. Having a no-subscription fee approach helps keep low adoption from being a deal breaker, she said.

“Employers like the idea that this is an embedded benefit,” she said. “It isn’t something that fits on top of the benefit design. … The other interesting thing, in a day and age where all national account customers are looking solely at cost, I’ve found most employers are not looking at this as a cost reduction solution. They’re focused on improving access for employees. They all are looking to see will this impact cost over time, but they understand that the cost differential between a virtual visit and an urgent care or primary care visit may not be as substantial as the cost savings they might see from presenteeism.”

Dr. Lena Cheng, VP of medical affairs at Doctor on Demand said that buy-in from UnitedHealthcare made a big difference in reassuring employers about telehealth. 

“There were many, many different companies we were talking to for months and it wasn’t until this integration went live that they were so quick to say, if United is putting it’s stamp on this, where do we sign up?” she said.

Both Cheng and Dr. Roy Schoenberg, cofounder and CEO of American Well, talked about the future of telehealth and how they might expand beyond urgent care and mental health, especially into chronic care and longterm care.

“We’ve got to stop thinking of telehealth as a monolithic product to give patients quick access to urgent care,” Schoenberg said. “Telehealth has a role to play that spans from urgent care all the way to end of life. It’s going to change how physician offices operate, it’s going to change how we discharge patients from hospitals, it’s going to change how we follow up and it’s going to change medical practice altogether. We’re beginning to understand that we are at the very beginning of this journey.”

One aspect of that is incorporating connected devices into video visits. The difficulty right now lies in the cost of the devices, Cheng said, and the fact that there’s a different hundred-dollar device for each biometric reading. But that could be mitigated by working with employers to provide or rent out connected devices to employees.

“What we’re seeing is interest from employers, who have a real vested interest in helping their employees and in reducing costs,” she said. “For instance right now we’re working with a large home improvement store. We’re running a pilot with the Cellscope otoscope with some families that have younger children, and the amount of money and time that’s saved by being able to distribute these otoscopes is just incredible and really encouraging.”

Cheng said that currently the biggest thing limiting adoption of telehealth by those who already have it through their insurer is just the momentum of the status quo.

“We’re still in this era where when people get sick they don’t necessarily think to use their mobile devices,” she said. “They think of calling a nurse line, calling their doctor or going to urgent care. I would say that our job really is to remove any barriers to utilization so that we can start to change that behavior.”