Most companies I work with think they've solved virtual healthcare. They have a telehealth vendor. They promoted it during open enrollment. They assume employees will use it.
They're wrong. Most employees want virtual care. They don't know which door to walk through, and neither do most benefits teams.
Why Employees Get It Wrong
Your health plan doesn't have one virtual care offering. It has three, and they don't talk to each other.
- The Standalone Telehealth App. You know the names: Teladoc and Amwell, plus a long tail of direct-to-consumer apps. Great for a sore throat, but the visit record stays inside that app. Your employee's primary care doctor never sees it.
- The Medical Carrier's Virtual Care. UnitedHealthcare, Aetna, and Cigna each have their own built-in virtual care. The doctors are part of your plan's network, but the copay can differ from the app's price and the employee has to log into the carrier portal, not the wellness app.
- The Specialist Silo. Talkspace for therapy, Ro for weight loss, Omada for diabetes. Each needs its own account and login. Your employee ends up juggling several health apps while their PCP knows nothing.
Most employees pick a door at random or skip the visit entirely, and that costs you money and morale.
What Fragmentation Costs
A client of mine had a high-deductible plan. They offered a free telehealth service through a point solution, but they also had a carrier-based virtual care option with a $50 copay. Employees didn't know which to use. Many picked the wrong one, got charged $50, and complained to HR. The benefits team spent weeks untangling claims.
The real issue is access parity. An employee's cost shouldn't depend on their ability to guess the right portal, but that's exactly what happens when the system is fragmented.
One Routing System for Three Doors
I've seen a few employers fix this without adding more apps. They build a single routing layer in their benefits platform. Care navigation vendors such as Quantum Health, Accolade, Rightway, and Included Health now sell this as a service, one front door that routes each employee to the right vendor and stays involved through the visit. The routing logic works like this:
- When an employee logs into the benefits portal, they answer one question: "What's your reason for a visit?"
- For an acute issue like a cough or a rash, the system sends them to the standalone telehealth app, which is fast and cheap and doesn't need continuity.
- For a chronic condition like diabetes or hypertension, it routes them to the carrier's virtual care, where the visit syncs with their medical record.
- For mental health or specialty needs, it directs them to the specialist platform, but only if that employee has already been onboarded there.
Most benefits teams still hand employees a list of links and hope for the best.
Data Integration and Network Audits
First, mandate data integration in your vendor contracts. Require HL7 FHIR and the CARIN Alliance's FHIR implementation guides. Every contracted virtual care vendor should send visit summaries back to your carrier. This clause only binds vendors you sign with directly, so it covers the carrier and the point solutions you pay for, not a direct-to-consumer app an employee bought on their own.
Second, run a quarterly network audit. Check whether your standalone telehealth panel overlaps with your carrier's virtual panel. If the same doctors appear in both, you're paying twice. Renegotiate or consolidate.
Point Solution Sprawl Created the Three Doors
None of this happened by accident. Each door arrived in its own contract. A Wellframe study found half of employers manage between four and nine point solutions, and Castlight's analysis puts the average large employer at 12 health-focused solutions. Only about 10% of employees regularly use the health solutions their employers offer, and a 2023 WTW survey found 41% of employers feel they already have too many point solutions.
The routing system doesn't ask you to fire your point solutions. It puts a single entry point in front of them, so employees stop getting confused as the vendor list grows. Consolidation can come later, on your own schedule.
Treat Telehealth as a Portfolio
The care itself is fine. The access layer around it breaks down. Stop treating telehealth as one benefit. Treat it as a portfolio of three doors, build one routing system, and train your teams to explain each door. Utilization and satisfaction rise, and frustration drops.
Because when employees stop guessing which door to use, everyone wins.