By AMI Parekh
A bit of sight Telehealth Safe Harbor willing Hidden inside the only beautiful beautiful bill was a significant milestone in virtual care. He thought that specifically addresses the services of prededucated telesalud in the high deductible health plans, the legislation has a greater implication for the provision of care and the design of injustice, as special in the commercial insurance market. In fact, the permanent extension of a Pandemia-Ire policy is a clear signal for health insurers that a new era or virtual care is being carried out.
The disposition, which permanently extended a policy of the era of overdue pandemic, is a Win for employers and workers. After five years of uncertainty, employers are now empowered to provide telesalud services to their entire workforce in Little or no costwhich has been sampled to reduce access barriers and Close the gaps in care. For self -financed employers in the injectors, this flexibility in shared costs combined with an increasingly sophisticated ecosystem or virtual care providers will be a greater innovation in the benefit strategy and the well -being of the workforce.
Obviously, this innovation led by the employer is also changing the virtual care scene for a key partner: health plans. Although 20% of the employer’s contract directly with specialized telesalud suppliers, 78% trust their Health Plan Partners – AND wheat Suppliers: To provide telesalud services for employees. As employers review their long -term virtual care strategy with a new guarantee following the secure port provision, health plans have an important seat on the table.
However, that seat is heating. In a year when the employer’s medical care costs are projected To increase by more than 9%, employers are examining their associations and planning the design to ensure that virtual care solutions are valued for their employees and their results.
In a new annual survey Of The Business Group On Health (BGH), more than three quarters of the employers said they are actively eliminating underutilized programs and low performance suppliers, or are considering doing so. Employers are also Intensifying expectations in RFPEvaluation of possible health partners in a growing list of factors and capacities that include performance guarantees, product and networks, reports and analysis, and membership experience.
From this point of view, Safe Harbor’s disposition is a call to action for health plans to evaluate their own strategy and virtual care associations through an employer’s lens. Three arees are especially important:
1. Quality
In the BGH surveyEmployers cited navigation to higher quality suppliers and the transparency of battery as the main priorities and virtual attention is no exception. In last year’s survey, half or all employers expressed groups About the quality of virtual care.
As with brick and mortar suppliers, the quality of virtual care varies widely between individual organizations and doctors. However, quality frames for virtual care I have not done the rhythm With advances in technology and rapid expansion in use cases. Now that virtual care is completely integrated in the provision of care and patient experience, medical care buyers, including employers and public sector organizations, as well as the health plans necessary to modernize the quality first. The key questions include:
- How do suppliers ensure that their doctors follow the clinical guidelines?
- How rigorous is the clinician accreditation process?
- Does the supplier network include experience in high need specialties (such as adolescents’ mental health) that faces the shortage of acute suppliers?
- Are accredited quality management programs instead?
- How does the supplier qualify in key measures in areas such as the management of the chronic condition and the continuity of attention?
As virtual and hybrid attention becomes the standard, buyers must begin to evaluate all Suppliers with the same rigor regardless of the configuration.
2. Integration
The boom in La Telesalud in the last decade has a double -edged sword. While the market offers more options than ever before, the large number of solutions has become defense For benefits to leaders and employees equally. In fact, virtual care has become as isolated as traditional medical care; almost 60% or employers cite The lack of integration between virtual care solutions as a challenge.
Go beyond narrow and transactional care that defined the Telehefal 1.0 Era, the main virtual virtual suppliers are breaking down by the construction of urgent care voltage networks, primary care, behavior health and second opinions of specialized care for experts in hospitals and traditional health systems. Critically, virtual suppliers should first have a high quality EHR connected to doctors that their patients are seeing in person, which allows the continuity of care in all environments.
Like the transmission services on our phones and televisions, people and buyers do not want fragmented (and underutilized) applications and subscriptions of a different suppliers. They want a central set of services adapted to their needs in a unique and cohesive experience. Health plans have an important role to play to make this integration and consolidation possible.
3. Innovative plan design
Employers seeking to control costs are doubling designs of alternative plans that encourage High quality and high value care. In a recently McKinsey reportMore than 85% of employers who consider models based on the value expressed great interest in flexible co -payment and deductible plans of the first dollar, except the type of flexibility and innovation, Safe Harbor’s legislation intended to promote.
Virtual and free virtual attention has proven to be a powerful lever to improve clinical and financial results. In 2020, for example, Walmart, the largest private employer in the country, was associated with the health included (where I serve as health director) to prove the impact of offering virtual primary care of $ 0 and a low -cost virtual therapy and psychiatry with its associates, approximately 50% of which did not have a previous established primary care provider. Around the next three years, a CASE AND CONTROL STUDY Found, integrated services closed the gaps in care and reduced ER visits and hospital stays, reducing the total cost of care by 11%.
Walmart’s example highlights how innovative approaches to plan the design and exchange of costs, together with integrated and longitudinal virtual care, the cane eliminates traditional access barriers and directs employees towards high quality care that they cannot always. Health plans and service providers focused on virtual models based on value will have a strategic advantage as this trend replicates the impulse.
A new era for virtual care
The safe port provision stressed that virtual attention is here to stay. But with the power of permanence comes new challenges and greater expectations. As employers and workers increasingly resort to virtual attention for a broader range of needs and services, health plans and their virtual care partners must work more to anticipate those needs, provide integrated high quality services and explore care. Those who are not at the time can be found in the sea.
AMI Parekh is the Director of Health of Health included.
