American businesses have historically fulfilled a wide variety of roles for workers beyond that of “employer.”
Ilyse Schuman
Senior Vice President, Health Policy, American Benefits Council
Most obviously, as health plan sponsors and retirement plan fiduciaries — and as innovators — U.S. companies have traditionally played an integral role in the health and financial wellbeing of employees and their families.
With the onset of the COVID-19 pandemic, employers took on an even greater role: suddenly, retailers, restaurants, and manufacturers had to become experts in public health and safety while facilitating access to healthcare.
Almost immediately, employers recognized two critical areas of need and sprang into action.
The abrupt, urgent need for both healthcare and social distancing, called upon employers to expand the availability of telehealth. While telehealth was already growing, a byproduct of evolving technology and increasing convenience, utilization exploded–we witnessed a year-over-year utilization increase of more than 8,000% by April 2020. Telehealth became a vital lifeline to care for thousands if not millions.
The telehealth revolution was critical for employers seeking to meet the second critical area of need: the mental and behavioral health crisis laid bare and exacerbated by the pandemic and its attendant crises–economic disruptions, social isolation, and civil unrest.
Companies swiftly enhanced their menu of solutions, including access to employee assistance programs, mobile wellness applications, and peer counseling. But it was telehealth that allowed employees to take full advantage of expanded coverage, especially in rural areas or communities with a limited number of mental health providers.
Policymakers certainly supported employer efforts to broaden the reach of telehealth services while relaxed restrictions on providers expanded their utility. Most notably, the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily allowed first-dollar coverage of virtual care under health savings account (HSA)-eligible, high-deductible health plans.
This flexibility expired as planned at the end of 2021. After the first few months of 2022, however, Congress was able to pass an extension of the provision for April to December 2022. Legislation that makes the provision permanent is critical to ensure that the benefits of telehealth continue both during the pandemic and beyond.
As an inadvertent proof of concept, the pandemic has revealed the vital importance of telehealth and mental health for employee wellbeing, which translates to greater public health and economic stability. As with any experiment, however, the work is not done when the experiment ends.
Employers are urging policymakers at the state and federal level to break down remaining barriers to telehealth, including mandates that patients have a preexisting relationship with the provider and restrictions on audio-only mental health services. With clouds as dark as they have been lately, the silver linings can be hard to see. But telehealth has come into focus as a silver lining of the tumultuous past few years and a vison of value-driven and accessible healthcare in the future.