Telemedicine
For more information contact:
Lee Shoemake
Lee@FlexCare.com
(404) 846-4100

Managing Healthcare Costs
Corporate America—The Challenge
 Employers have been, are
currently, and will continue to
seek creative solutions to
reduce absenteeism, increase
productivity and decrease
overall healthcare costs.
 They have been forced to
restructure their benefit plans.
 With more people entering
the system, a shortage of
physicians and increased
waiting times, innovative
solutions are needed.

Managing Healthcare Costs
We Have a Solution:
FlexCare offers an innovative, timely
and sensible solution.
This program offers convenient,
accessible and affordable
healthcare.
 These benefits offer the
employee and his/her entire
family thousands of dollars in
savings.
 At the same time, it offers the
employer those creative
solutions they seek.

Health Care Reform and Telemedicine
We are about to have a severe shortage
of primary care physicians
What Will Happen?
 Individuals will ignore symptoms
and delay treatment which can
lead to more serious medical
complications
 Individuals will leave work for
minor issues which results in
absenteeism, loss of productivity
and unnecessary costs
 Individuals will continue to
overuse Urgent Care and
Emergency Rooms

The supply-demand gap
The demand in the number of yearly PCP consults
due to population increase and expanded
coverage will drive the need for more PCPs.
POPULATIONBASELINE AGING ACA EFFECT (health reform)
280,000
240,000
200,000
160,000
2010 2025
"Projecting US Primary Care Physician Workforce Needs:
2010-2025"; Stephen M. Petterson, PhD, Winston R. Liaw,
MD, MPH, Robert L. Phillips Jr, MD, MSPH, David L. Rabin,
MD, MPH, David S. Meyers and Andrew W. Bazemore, MD,
MPH; November/December 2012
ADDITIONAL PCPs NEEDED
52,000
Additional PCPs
needed by 2025

Average appointment wait times (in days) for five medical
specialties included in the Merritt Hawkins Survey (2010).
Family Practice wait time was 20.3 days on average
Average appointment wait times (in days)
Seattle 14.2
Portland 14.4
Minneapolis 19.8
Detroit 12.0
Denver 15.4
Los Angeles 24.2
San Diego 20.2
49.6 Boston
19.2 New York
27.0 Philadelphia
22.6 Washington D.C.
11.2 Atlanta
19.2 Dallas
23.4 Houston
15.4 Miami

Employer adoption of telemedicine
Workplace telemedicine is a growing trend, and one that is
gaining increasing attention.
• “Health care delivery and treatment
settings continue to evolve, leading to
the acceleration of alternate network
strategies, including high-performance
networks, third-party providers and
telemedicine.
• For example, 17% plan to offer
telemedicine by 2013, and another
27% are considering it for 2014 and
2015.”
• The Challenge: Most telemedicine services have had low
utilization rates due to two significant barriers.
• FlexCare has eliminated these barriers.
1 Health Care Changes Ahead Survey Report, Towers Watson, October, 2012. Link:
http://www.towerswatson.com/assets/pdf/8139/TW-HealthCare-Trends-Survey-NA-2012.pdf
Source: Towers Watson, Health Care Changes Ahead Survey Report, October
2012
http://www.towerswatson.com/en/Insights/IC-Types/Survey-Research-
Results/2012/10/health-care-changes-ahead-survey-report

Healthcare Trends
Access Points for
Healthcare
1. Medical Offices will be
overcrowded
2. Walk-in Clinics–-Groceries and
Pharmacies
3. Overuse of Urgent Care and
ER Clinics
4. Telemedicine—Doctors by
phone or online video will be
the solution– telemedicine
will represent the navigators
of the future

“Telemedicine has the potential for restructuring
medical care in ways that can solve many of
the problems, while reducing costs and
improving quality of care.”
National Center for Policy Analysis
Convenient Care and Telemedicine White Paper, November 2007
“Telemedicine will play an increasingly central role in getting
the right care at the right time to individuals…particularly
effective for acute, routine, episodic, self-limited and
minor illnesses.”
Telephonic Medical Consults Answer the Call for Accessible, Affordable and
Convenient Healthcare. Position Paper. Center for Health Transformation.
The Challenge: Most telemedicine services have had
low utilization rates due to two significant
barriers—communication and cost. FlexCare has
eliminated these barriers.

Introducing Teladoc
Teladoc is quality healthcare made simple, on your terms,
when and where you need it.
• An affordable alternative that allows members to resolve
many of their medical issues 24/7/365 through the
convenience of phone or online video consultations.
Anytime. Anywhere.
• Provides members with access to a national network of
physicians who can diagnose, treat, and prescribe
medication, when appropriate, for many medical issues. All
physicians are U.S. board-certified and licensed to practice
medicine in your state.

An Innovative Solution
Providing solutions for three of the biggest issues in
healthcare:
• Timely access
• Lower cost
• Quality care
Employee / Member
satisfaction is one of the
many benefits of addressing
these issues

What can it be used for?
Top 10
Diagnoses
• Sinus Problems
• Urinary Tract Infection
• Pink Eye
• Bronchitis
• Upper Respiratory Infection
• Nasal Congestion
• Allergies
• Flu
• Cough
• Ear Infection
• Headaches and Migraines
• Stomach aches
• Prescription refills
• Electronic prescribing
(SureScripts) or by phone if needed
• Frequency of prescribing similar to provider
practice (about 75%)
• Use of antibiotics limited to short durations No
prescribing of DEA-controlled substances,
medication for psychiatric illness, or lifestyle
drugs (i.e. erectile dysfunction, diet, etc.).
• Generic drugs are automatically recommended
Prescription
Management

Prescribing of Medications
Teladoc's prescribing patterns are similar to those found in
face-to-face consultations.
PRESCRIPTION RATE GENERIC PRESCRIPTION RATE
80%
TELADOC
83%
PCP/ER
98%
TELADOC
Teladoc prescriptions
are for durations of
30 days or less

Teladoc provides non-emergency medical assistance when a
doctor is not available.
• When the physician is unavailable and cannot be seen on a timely basis
• Schedule doesn’t permit traveling to see your physician (work, etc.)
• On vacation or a business trip
• For refill of recurring prescription (short term only)
• Geographical barriers (distances to a providers office)
• Pediatric care for any age
When can it be used?

Where can it be used?
Teladoc is compliant with current state regulations in order to
operate in 50 states.

How does Teladoc work?
An employee has cold-like symptoms but doesn’t have the time to sit in an
urgent care waiting room. Instead they call Teladoc:
Step 2.
Request consult
Step 3.
Talk with a physician
Step 4.
Resolve the issue
Step 6.
Results
They simply log on to their account or
call Teladoc, 24/7/365, to request either
a telephone or video consultation.
There is NO CONSULT FEE with
FlexCare.
A board-certified physician licensed in
their state reviews their medical history
and provides a consultation over the
phone or through video, just like an in-
person visit.
The physician recommends the
right treatment for their medical
issue. If a prescription is necessary,
it is electronically sent to the
member’s pharmacy of choice.
Your member’s medical issue gets
resolved saving time and money.
Step 1.
Medical history
Member receives fulfillment kit with
instructions. Member is required to
complete their medical history
online, by phone, or by faxing a
paper form prior to requesting a
consultation.
Step 5.
Continuity of care
The physician documents the results of
the consultation in the member’s medical
history. Consultation information can be
sent to the member’s primary care
physician.

The highest quality care
By directly managing their own network, all doctors are:
97%
Teladoc physician
satisfaction rate
Board-certified Board-certified and state-licensed in internal medicine, family
practice, emergency medicine or pediatrics.
Experienced Experienced, with an average of 15 years of practice.
Primary Source
Verified
Verified through the National Practitioner Data Bank (NPDB) and
the American Medical Association (AMA) Board certification,
work history, peer reference, State licenses, monthly state
sanction reports, DEA license, criminal and civil background.
U.S. residents U.S. residents, living and working in the United States.
Connected Message Center enables our physicians to follow up with members
inside the secure member portal. Easy-to-understand educational
articles are available to provide to the member to help them
understand their specific diagnosis.

Supporting the patient – physician relationship
Teladoc reinforces that telehealth is not a replacement for the
patient’s PCP
• Member communications reinforce importance of
PCP relationship
• Every patient is asked before every consult if they
would like a copy sent to their PCP
• Patient does not select their Teladoc physician or
develop an on-going relationship
• Overutilization of Teladoc services closely
monitored.
Teladoc supports the
Patient / Physician
Medical Home
Teladoc refers patients
to their PCP for any
follow up care

100%
Consults by new docs are reviewed
for the first 3 months or after 10
consults
15%
Consults reviewed if physician
conducts more than 10 consults in
a month
1,500
Charts reviewed on average per
month in 2013.
Teladoc physicians are constantly reviewed to ensure a high
level of quality care.
WHAT WE DO THE RESULT
91%
Patient medical
issues resolved
9% unresolved:
4% referred, 2% out of scope for telehealth, 2%
seeking meds only, 1% sent to the ER

Teladoc quality management
Processes and systems in place to ensure quality consultations.
Teladoc pursues
excellence through
quality assurance and
improvement.
• Before each doctor performs a consultation, all sections of the
medical report must be reviewed and noted as performed
• Evidence Based Medicine and clinical guidelines embedded with
hyperlinked references for each consultation
• Rigorous network management to deliver highest quality medical
care
• Prescriptions are sent electronically to the patient’s pharmacy
• Patients are educated that antibiotics are not beneficial for colds
or flu using the CDC “Get Smart” program and physicians are
reminded the appropriateness using the CMA Foundation AWARE
• The patient's medical record is updated following a consultation,
sent to the health plan and can also be sent to the patient's PCP

Video
http://youtu.be/rCZYjvUjkoQ http://youtu.be/pYededbGbeM

Making access easy
Teladoc’s mobile application allows members to set up and
manage their account, as well as conduct video consults
from their mobile device.

Teladoc Facts -- 2013
Telehealth’s time has come.
Based on Teladoc reporting and member surveys
97%
Member Satisfaction
125,000Consultations in 2013
99%+Client Retention
0Malpractice Claims
1hour
Guaranteed Response Time
91%
Patient Issues Resolved
Teladoc is the first and largest provider of telehealth medical consultations
in the United States. Not only do they have the most experience, they have
the results to prove it:

What the Employer Can Save
A benefit of telehealth is appropriate redirection of utilization to an affordable alternative.
• Base on Teladoc reporting. Actual savings may vary based on geography.
IF THEY DIDN’T HAVE TELEMEDICINE, WHERE WOULD
THEY HAVE GONE?*
HOW MUCH WILL YOU SAVE WHEN MEMBERS USE
TELEMEDICINE CONSULTATION?
33% Urgent care
1% Specialist
43% PCP
15% Nothing
ER
Urgent care
Specialist
PCP
Avg savings per consult
Productivity savings**
Total savings per consult
$155.40
$86.96
$242.36
** Approx 4 hrs lost @ avg wage of 21.74/hr
based on US Dept of labor data
$752
$122
$152
8% ER
$102

Communications
We help you drive utilization by providing targeted marketing materials
FlexCare communications include:
• Fulfillment Kit to each household
• Can all be co-branded for client
• A variety of marketing pieces
 Welcome Letter
 Getting Started
 Monthly Campaign
 General Reminders

The following have been found to drive utilization:
• Send Member Kits and Cards
• Include Teladoc information in benefit summary next to PCP co-pay
• Highlight Teladoc during open enrollment
• Highlight NO MEDICAL CONSULT FEE feature
• Market to members several times a year – especially during cold/flu and allergy seasons
• No two clients are alike: understand what messages and communication vehicles resonate
best with population.
• Use of emailand text messaging as a communication vehicles
• Leverage employer’s logo/brand
• Develop and agree to year long marketing strategy and plan in advance; review every 6
months, based on results
Drivers of low utilization include:
• Not communicating
• Burying Teladoc information in the benefits package
• One size fits all marketing
• Not personalizing (co-branding, using company name)
Build awareness and drive utilization

The value proposition
Telemedicine addresses the biggest healthcare issues and FlexCare eliminates the barriers to utilization.
FlexCare has eliminated all barriers affecting utilization by
offering this benefit with
 NO MEDICAL CONSULT FEES
 COMPREHENSIVE COMMUNICATION PLAN.
 Provides comprehensive 24x7 access to appropriate care for
all employees regardless of work location or travel
 Significant impact on inappropriate ER and UC utilization;
lowers self-insured healthcare costs
 Reduced absenteeism and increased productivity
 Highest clinical standards found in the industry
 Valued benefit offsetting perception that benefits are being
reduced as employee contribution is increased
Access
Satisfaction
Quality
Cost
Productivity

Other Features
 List-bill capabilities
 Fulfillment Kit and Membership Cards
 Website Access to benefits and provider locators
 Onsite member services call center staffed with English and
Spanish speaking representatives who can help with
enrollment, verify discounts and assist with customer service
issues.
 Compliance Department monitoring state legislative
requirements
 All benefits are good for the immediate family

Other Benefits
Emergency Travel Assistance
Members have access to a global network of practicing
physicians, travel assistance personnel and emergency
evacuation benefits when traveling 100 miles from home and
suffering a serious injury or illness. Knowing help is merely a
phone call away provides members with peace of mind.
*Travel Assistance not available to Florida, Oregon and Washington
residents
Fitness Club Discounts
International Fitness Club Network
Guaranteed lowest rates at over 8,500 quality fitness centers
nationwide. Introductory Free Week Trial to all clubs. All
meet ACSM guidelines.

How to Sign Up—Pricing based on group size
GROUPS
 List Bill Agreement
 Eligibility File