Efficient access, effective outcomes, enhanced experiences
Challenges continue for health plans to deliver whole-person care to members
Health plans face the traditional obstacles they always have, while also encountering new challenges that continually surface. From making progressive steps in health equity to managing provider shortages and cost of care, it can be difficult to address each of these issues and ensure the best experience for your members.
Financial uncertainty creates its own set of issues. A recession could shrink enrollment, particularly at a time when the government is set to roll back consumer protections. These protections have been instrumental in keeping millions enrolled in government-sponsored plans during the COVID-19 pandemic. Analysts predict that losing members could put downward pressure on both the top and bottom line for insurers.
To deliver value to members, virtual care must shift to high-value care
As the consumer adoption of virtual care continues to spread, the service must deliver quality care in order to remain competitive and keep members coming back. While virtual care peaked in spring 2020 with many people seeking urgent care due to the COVID-19 pandemic, utilization has since leveled; however, some telehealth experts predict that digitally delivered healthcare will continue to grow.
Many of the realized benefits of virtual care will continue as patients searching for care shift from urgent needs to managing chronic conditions. For those living in healthcare deserts, virtual care can be the only option for finding the necessary care for unique needs.
For example, while almost half of American adults have hypertension, the average wait time to see a cardiologist is over 26 days, a 26% increase since 2017.
Even with advances in virtual care delivery, there are still gaps in adoption and education, especially among underserved populations. Some are questioning whether virtual care is able to deliver on the promises that it made, including increasing access to providers. Specifically, disparities in adoption continue to persist among lower income Americans, rural Americans, and older Americans.
Virtual care will increasingly be held to the same clinical standards as in-person care—as it should, and the coming years will bring more emphasis on quality and safety.
Now is the time to ask yourself:
Does your partner in virtual care deliver high-quality care and clinical outcomes?
Expectations continue to rise
It’s not enough to simply be convenient—virtual care must also be effective. Your employer clients want a high-quality, easy-to-use, comprehensive healthcare product for their employees that keeps them happy and healthy and that is designed to support the diverse workforce they employ.
A top priority among employers is taking action on diversity, equity, inclusion, and belonging (DEIB) goals. Creating an environment where employees feel supported includes building a benefit suite that is inclusive of all employees needs.
That can include increasing access to providers who come from diverse backgrounds and lived experiences. Members living in a rural area or a healthcare desert may not have the opportunity to see a provider who looks like them or who is familiar with how healthcare needs differ for Black, Indigenous, and People of Color (BIPOC), as well as LGBTQ+ communities.
And of course, clients are looking to deliver expanded access to high-quality care, whether that means 24/7/365, nation-wide, with minimal wait times, or all three.
A strategic partner to deliver efficient access, effective outcomes, and enhanced experiences
To address these challenges, health plans should look to their strategic partners to help:
- Design innovative offerings that support a health plans’ goals and members
- Drive utilization of virtual care offerings effectively
- Deliver a virtual care experience that offers more than convenience for members
Designing innovative offerings that deliver solutions, together
There is not one all-encompassing solution to healthcare’s toughest challenges—that is where there is power in partnership. Included Health has partnered with health plans of all sizes, serving all types of member populations, to improve access, and health outcomes for millions of members.
From virtual-first primary care plans to the first ever Medicare Advantage Plan for LGBTQ+ older adults and everything in-between, we’ve continued to innovate with health plan partners to meet members where they are and deliver the high-quality care they need.
Driving member utilization and engagement
At Included Health, we think about member engagement as a framework with three strategic pillars—placement, promotion, and endorsement. It’s the combination of these three that can drive a successful strategy of engagement and utilization.
Placement is vital to ensure that members know where to begin their care journey. Being highly visible and accessible when members are thinking about their healthcare options is a crucial component of a joined engagement strategy.
Promotion is the invitation extended to your members to engage with available programs and offerings, at the right time. Leveraging a combination of targeted, seasonal, and lifecycle member campaigns can help ensure you’re top-of mind when there is naturally a high-level of member interest in healthcare.
Finally, endorsement creates the trust for members to believe they have someone in their corner. A trusted advisor utilizing collaborative resources can guide members to the right site of care whether that’s virtual, in-person, or a combination of both.
Raising the expectations of your partners to deliver more
In order to highlight your virtual care offering as a competitive differentiator in the market, it must deliver more than fast access to care for the sniffles. Virtual care should be as comprehensive in treatment and as effective in health outcomes as traditional sites of care, with the added benefit of access to matter where you live.
Care delivered virtually was put to the test during the COVID-19 pandemic, but now is the time for it to deliver quality care, even for chronic conditions. For example, Included Health showed that virtual care visits of hypertensive patients demonstrated an improvement in blood pressure in 77% of members.
These results highlight that virtual care, delivered by high-quality physicians and providers, offers an efficient, effective, and patient-centered approach to address important gaps in hypertension management, including access to care and patient satisfaction, with patient satisfaction scores of 4.94 out of 5.
Mental healthcare is an essential part of a member’s overall wellbeing. A growing area of focus since the pandemic has been behavioral health, and in a recent study 79% of psychologists reported an increase in patients with anxiety disorders, while 66% saw an increase in demand for treatment for depression. Included Health has delivered real-world impact through meaningful clinical outcomes for behavioral health needs. 86% of members experienced an improvement in depression symptoms and a 47% total PHQ-9 score improvement after four psychiatry visits, with similar numbers after eight therapy visits.
Whether a member needs physical or behavioral treatment, they are on a healthcare journey guided by their provider. Utilizing an employed provider model, Included Health’s virtual care creates the opportunity for provider and patient to build a trusting relationship. By seeing the same provider during each member visit, patient satisfaction is increased along with adherence to care plans and, consequently, improved outcomes.
Advancing a plan’s offerings means staying one step ahead of member expectations. As virtual care becomes more prevalent, it must shift from just being about quick access to a doctor, to becoming a solution where some of healthcare’s most complex diagnoses are treated. From urgent care needs in the middle of the night to chronic conditions like hypertension and diabetes to a full range of behavioral health needs, your virtual care partner must deliver convenient and effective care across the entire continuum of care.