Will Consumers Pay-Out-Of-Pocket For Online Healthcare?Will Consumers Pay-Out-Of-Pocket For Online Healthcare?

If you suspect your extra-cranky baby has an ear infection on a Saturday afternoon, but his doctor isn't back in the office till Monday, a walk-in clinic--like the kind springing up in places such as retail pharmacy chains--can be a convenient place to get the ear checked. But if it's the middle of the night, what do you do?Starting in late 2009, consumers will be able to hook up with physicians and other clinicians online any time of day via two-way video, webcam, secure chat, or phone. An alliance between American Well, which provides a secure online health marketplace, and OptumHealth, a subsidiary of UnitedHealth, is setting the stage for a nationwide, 24-by-7 telemedicine service that links consumers with healthcare professionals in their states.

OptumHealth is working with employers to provide the telemedicine services as a covered health benefit to workers. However, as the service is rolled out in a given state, OptumHealth is planning to make the telemedicine offering available to consumers for a fee, whether or not they've got healthcare coverage.

The concept "is like Minute Clinic," said OptumHealth Care Solutions CEO Rob Webb, referring to the walk-in health clinics operated by drug store chain CVS. The biggest difference is that OptumHealth's offering of healthcare services will be delivered via the web, he said.

Over the last couple of years, a number of retailers have begun opening these walk-in clinics, including CVS, Wal-Mart and others. While those facilities provide convenient in-person healthcare services in local store settings, the telemedicine services offer the added convenience of being able to consult with a remote healthcare professional from home, the office, or wherever the patient is.

For OptumHealth's online offering, all of the providers, which range from general practitioners, to specialists and behavioral health professionals, are certified and are part of UnitedHealth's provider network.

Patients will be able to select the provider based on several criteria, including the first available provider in a given specialty; name of clinic/practice affiliation; and other factors important to the consumer, such as gender or language, i.e. a doctor who speaks Spanish. Consumers will also be able to review the provider's profile online. If a patient's regular primary care physician participates in the program, the consumer can be alerted when that doctor is online.

OptumHealth will be offering these services via an alliance announced in June with American Well, which provides a secure, Web-based, voice-over-IP enabled platform that facilitates for patients on-demand, real-time "virtual consultations" with medical professionals. Patients and clinicians can communicate through phone, Web cams, video conferencing, secure messaging, or secure chat.

On the back-end, information about the patient can be provided to the online healthcare provider from a number of sources, including medical and pharmacy benefits claims, as well as predictive modeling tools--which can look at longitudinal health records, and help nudge providers to ask whether a diabetic patient has had an eye exam recently, for example.

"When we're deploying a system with a health plan, we bring this all together," said Dr. Roy Schoenberg, American Well founder and CEO. American Well is also connected with Microsoft personal health record platform, HealthVault, also allowing consumers to share their health information with providers during the Online Care encounters.

For OptumHealth, behavioral health services are an area where on-demand telemedicine services could be a big draw among consumers, said Webb. "A lot of behavioral health is self-paid," he said. Even when patients have behavioral health coverage via their employer benefit plans, some individuals "don't want to run [the bill] through their plan" because of fears about privacy or other concerns.

American Well's platform is already connecting U.S. military service personnel and their dependents in Hawaii with mental health services via the web through a partnership with Triwest Healthcare Alliance.

Webb predicts that some patients will seek online services to address an occasional or unplanned healthcare need, but that the services will catch on because of their convenience. "It'll start out as episodic visits, like getting help with crying babies…but we want [the online care] to become more mainstream," he said.

American Well's Schoenberg said an online healthcare encounter is "30% to 40% less expensive" than a regular office visit.

If the price was right, would you be willing to pay-out-of-pocket for an online visit with a healthcare provider? What sort of healthcare would you be willing to get online?

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