Does Insurance Cover Therapeutic VR for Hospital Care?
Unfortunately, not quite yet. It is possible that some insurance companies will soon see the benefits of covering therapeutic VR as a bona fide, evidence-based and effective medical treatment. But at the moment, we are not aware of an insurance company that is routinely paying for VR. Instead, most hospitals directly support VR programs on the theory that they save costs by reducing the need for expensive medications and their costly side effects, improve patient satisfaction, or reduce hospital length of stay.
To help insurance companies and healthcare payers understand the potential return on investment (ROI) of supporting therapeutic VR, our team conducted an analysis with one of our talented graduate students, Sean Delshad, to evaluate the cost-effectiveness of using VR in the hospital. We performed health economic modeling that incorporated costs related to VR implementation, potential savings from decreases in opioid usage and time in the hospital, and effects on patient satisfaction scores that are tied to federal reimbursement for healthcare services. We then performed analyses to create a an ROI lookup table for hospitals of varying size and overhead costs that are contemplating whether to start a VR program.
We found that using VR is very likely to be cost-effective for most hospitals. In particular, among patients eligible and willing to use VR, we projected an average overall savings of $98.49 per patient compared to not using VR. In other words, the small additional costs of paying for a hospital VR program are offset by savings engendered by the benefits of the VR. Although saving only $98.49 per patient is a relatively small amount, a VR program can pay substantial dividends when this value is multiplied over tens and thousands of patients per year. When we tested the health economic modeling over and over again in a simulation of 1000 different hypothetical hospitals, we found that VR remained cost-saving in 89% of the simulations compared to usual care. If you consider all the expensive resources that insurance companies cover, like paying for multimillion dollar robots to perform prostate surgery or using hemodialysis machines in patients at the very end of their life, then buying some cheap headsets and training technicians to apply them to patients seems like a low cost intervention for insurance to support. And if it works while saving money at the same time, then why not pay for it?
You can read the full study at this link here.