Those prospective customers who had no healthcare insurance were very unlikely to prepay anything, and those who were insured wondered why Beth Israel was not participating in their own insurance. "So what intuitively seemed like a logical idea to us met resistance because of barriers, even though they were low-level barriers," he says, adding that even for those with insurance, between copays and deductibles, traditional visits still would have cost more than accessing the service. "But I think it's more a psychological barrier."
Last September, Beth Israel added an option to pay $48 a visit without an annual registration fee, which Henick says is significantly less than the cost of a doctor office visit in New York. "We're not getting a particularly robust response to it," he says, so now Beth Israel is modeling the service with its own employees, who pay $15 per Teladoc consultation.
"Every person that goes on Teladoc, one of the initial questions is, 'Where would you have gone for service had you not chosen this option?' so we're collecting that data and seeing what the cost would have been had they not accessed this service, and then balanced it against our cost of picking up the cost of the visit above $15," Henick says.
This time, Beth Israel's internal usage reflects a return of 7 to 8 times the investment required, and as soon as it has collected a sufficient sample, Henick believes it can return to its payers with this data and its direct-to-consumer product will be able to get insurance company participation and enable the service to take off.
Henick sees it all as an extension of Beth Israel's earlier forays into urgent care centers. And the way Beth Israel Medical Group has arranged its Teladoc partnership, all calls go first to its own tier of doctors who have joined the Teladoc network. If call volume rises such that response times lengthen, other patients would be routed to non– Beth Israel doctors, who are licensed in New York and credentialed by Teladoc, Henick says.