Explosion of Virtual Healthcare Usage


By:  Rory P. O’Brien,  RPO Group Benefits + Consulting

Telemedicine is experiencing an overwhelming utilization due to the global  invasion of the Coronavirus .  In recent years, many Insurance Companies and Employers have been educating employees about the convenience of the various different Virtual Healthcare Companies.  It seemed to have been catching on, but very slowly.  That has all changed drastically now.  What a perfect tool it has become for this horrible virus.

Given the constant government warnings about our healthcare system being completely inundated with infected individuals, resulting in the request to not come to the hospital unless you are sure you have all of the symptoms of the virus, left an enormous amount of very nervous people who did not know what to do.   Almost immediately, the federal government announced the availability of Telemedicine for seniors on Medicare.  This was highly welcomed, particularly since this group was identified as the highest risk victims, along with the fact that it is very difficult for many elderly to leave the house, especially when they are feeling so sickly.  Plus, nobody wanted to go to a facility dealing with these victims if, in fact, they did not have it, for fear of contracting it while they were there.

Next, all non-essential employees in many states were told to stay home.  Many of them then received notification from their Insurance Company and Employers reminding of or announcing the Virtual Doctor option, along with the information that any copay charges would be waived.   Again, a perfect offering for so many people who were having some health symptoms like a sore throat, runny nose, cough, nausea, etc.  They were able to speak with a medical provider who could virtually diagnose their condition, a large percentage of which were simple colds or the normal flu.

I strongly believe that once this terrible virus has been eradicated, the newly introduced and familiarity of this valued convenient service will be far more frequently utilized going forward.  Now we just have to match up the number of providers with the new demand.






First Step Towards Replacing Obamacare

By: Rory P. O’Brien, RPO Group Benefits + Consulting

After many weeks of debate, last week the House of Representatives passed what is known as the American Health Care Act (AHCA). Next up, it will be put forth in front of the Senate for a vote.

Two topics which will be certain to get a lot of discussion and disagreement will be related to Medicaid and Pre-Existing Conditions. Under Obamacare, there have been an additional 16.7 million newly enrolled in the program. That represents a substantial majority of the total Americans who obtain their coverage under that act.

The new law as is currently worded, would roll back federal funding for this expansion, and introduce limits on federal Medicaid spending for the states. The House and the Senate will ultimately have to come to some agreement on this major area of concern.

Additionally, there is much confusion as to what extent the people with Pre-Existing Conditions will continue to be protected. It appears as though protections remain in place, just within different boundaries. This will have to be clarified to the satisfaction of the Senate. Undoubtedly, there will be strong resistance from the Democratic side of the Senate, similar to that which took place in the House.

Something must be done with the healthcare system in this country. Almost everyone agrees with that. It is a shame that all our representatives cannot find it within themselves to work together toward what should be the ultimate goal of a quality system that works for everyone.

Age 26 Provision Survives

By: Rory P. O’Brien, RPO Group Benefits + Consulting

To the delight of many, the new healthcare bill (AHCA)which was recently passed in the House, preserves the highly popular age 26 provision. I understand the popularity, but this feature is almost certain to doom, or at least significantly impact the desired results of the new plan, similar to its impact to Obamacare. The way it currently stands, the child who is 25 years old, great job, married with children of their own, and living in a different state can stay on their parent’s plan. Does this make sense?

In order for any plan design to be financially successful, it must have the inclusion and participation of the young and healthy. Yet, instead of incentivizing them to participate, this provision gives them no reason to even consider it. It’s as if the plan was designed by 2 different architects, with different considerations in mind.

The initial introduction of this concept came when the recession hit. It was to recognize and respond to the concern that newly college graduates could not find jobs…..and thus were left without healthcare coverage. So its purpose was well intentioned at that time. However, in my opinion, I think it should have been introduced with a “sunset” clause which expired upon the opening of the Healthcare Exchange. The Exchange would have provided access to coverage, while at the same time offering financial subsidies if there were still no jobs, or little income.

Now, here it is again. A more realistic design would be to make insurance available to only those under age 26 people who do not have employer/workplace coverage offered to them.