Late-night pains and illnesses may become less likely to lead to a trip to hospital emergency departments, as more New Jersey insurers are making doctors available to talk 24-7 with patients over the phone or through video links on a computer or mobile device.
The trend gained its biggest adherent yet when Horizon Blue Cross Blue Shield of New Jersey, the state’s largest insurer, recently unveiled Horizon CareOnline, which allows people with individual or family insurance coverage to talk via video with a doctor within two minutes of logging on. The service, which debuted January 1, is geared toward patients who aren’t able to reach their primary-care doctors.
The move to online consultations, known as "telehealth," is being driven by consumer interest in quick access to services. Two smaller insurers focused on the individual and small-group markets announced 24-7 consultation services before Horizon, and other large insurers are considering adding similar benefits.
However, a key part of many doctor visits – writing needed prescriptions -- has thus far been limited by uncertainty surrounding state regulations.
Horizon officials noted that no appointment is needed is talk to a doctor who’s licensed to practice in the state.
“Horizon recognizes that there are times when individuals cannot get to a doctor quickly or easily when they get sick, so Horizon CareOnline will go a long way to adding convenience to receiving care from a licensed physician,” said Christopher M. Lepre, Horizon senior vice president of market business units, in the statement announcing the service.
The Horizon service is being offered through American Well, a Boston-based company that developed a website and mobile application to connect patients and doctors.
It joins Health Republic Insurance of New Jersey – which in July became the first insurer to offer the service in New Jersey – and Oscar Health Insurance, which started offering insurance in the state this month and focuses on delivering care via advanced technology.
American Well started offering such services in 2007 in other states and has grown steadily since then, including working with more than 20 state Blue Cross Blue Shield companies. Skepticism about the service has lessened as more consumers are becoming comfortable with mobile applications, according to a company spokeswoman.
Patients have sought care for illnesses ranging from sinus infections and pinkeye to mysterious rashes.
Through American Well, patients have access to information to help them select a doctor, including looking at details of their medical licenses and where they attended medical school. The doctors, who are employed full- or part-time by Online Care Group -- a separate company -- are based in other states including New York but are licensed to practice in New Jersey.
American Well Vice President of Government Affairs Kofi Jones said the company has reached out to the New Jersey State Board of Medical Examiners “to get clarity” on regulations before the company can offer prescriptions as part of Horizon CareOnline.
Current state law requires that doctors perform a physical examination before prescribing drugs.
Until the service can offer prescriptions, the doctors will serve as trouble-shooters, able to offer patients diagnoses for conditions that can be diagnosed online, as well as guidance on whether they should immediately seek follow-up care or can wait.
The service is available at no cost to all individual and family insurance members who bought insurance through the federal health insurance marketplace, healthcare.gov, or directly from Horizon. Nonmembers can use the service for a $49 out-of-pocket fee.
While the focus is on primary care, behavioral health and nutrition consultations also are available.
Health Republic also offers 24-7 access to doctors by phone or online.
“We saw this type of innovation, service and access for our members as something that not only aligned with our member-centric mission, but also as part of our efforts to help our members stay healthy at no cost to them,” said Cynthia Jay, chief marketing officer for Health Republic. She said all members who’ve used its “Teledoc” service since the July debut have been satisfied with it.
New York-based Oscar Health Insurance touted its around-the-clock online access to doctors as a key feature of its services when it announced that it was entering the New Jersey market.
Further, Aetna offers 24-7 access to nurses; AmeriHealth New Jersey said it’s looking to add around-the-clock access to doctors; and UnitedHealthcare has had success with telehealth in other states, including Nevada.
The Medical Society of New Jersey, the state’s largest doctors group, has supported electronic consultations. The society has backed a pair of bills,/S-2337, which provides for Medicaid reimbursement for telehealth consultations, and /S-2338, which would require private insurers to reimburse for consultations. Both bills would require that the consultations offer both audio and video links and aren’t audio-only phone calls.