The Future of Primary Care is Here. Are You Ready?

With the COVID-19 pandemic almost in our rear-view mirror, we stand on the horizon of a profound change in healthcare: The evolution of primary care from a static provider relationship to a virtual care team in your pocket.

For decades, consumers have accepted a tenet of good care to be a primary relationship with a single doctor. This notion has been challenged in unexpected ways over the past 10 years due to a shortage of primary care physicians, increased medical specialization and a rapid shift to digital engagement among consumers. Contributing to our new reality, only one in four Americans have a primary care provider.

Russella

Virtual primary care offers a solution that is different from today’s urgent care telehealth solutions in that it enables a health plan to create a distinctly new kind of trusted relationship with its membership by supporting the formation of digital doctor-patient relationships. Virtual Primary Care providers are given a better look at the whole patient, assessing their mental and physical health along with other clinical insights from the health plan to guide patients in the best direction. This includes the ability to treat and prescribe when appropriate and to direct members to preferred sites of care—in terms of both cost and quality—when testing, physical examinations, or treatment are required. Inevitably, this results in better outcomes as well as savings from the use of lower-cost sites of care that will cover the costs of deploying a virtual primary care program.

Virtual primary care allows health plans to provide an innovative care solution to their members and the employers they serve, including:

1.) Re-energizing relationships between primary care physicians and patients they currently treat.
2.) Connecting with unengaged members who demonstrate rising risk.
3.) Attracting millennials and those without a primary care physician by offering a personal physician online.
4.) Offering a digital healthcare “companion” that is highly accessible, responsive and personalized.

Enhanced through integrations with a health plan’s clinical quality data, virtual primary care can immediately help to address gaps in care by proactively engaging members in addressing their health concerns.

As the new frontier of modern medicine, a virtual primary care strategy can be a key differentiator for the health plan, from attracting and retaining members and new employer clients to delivering a more immersive and highly engaging experience. Key considerations in deploying virtual primary care include:

1.) Make the experience of getting access to primary care providers more gratifying, easy and efficient. Recent surveys indicatemembers prefer connecting with a PCP virtually and would even switch to a PCP who offers virtual care. In instances where a PCP does not offer virtual services, one in four consumers would be willing to switch to a physician who does, according to Amwell’s 2020 consumer survey.

2.) Ensure a highly convenient, coordinated care experience. Best-in-class virtual primary care programs seamlessly integrate with specialty providers who are part of a plan’s preferred network and incorporate feedback from these specialists in the member’s comprehensive treatment plan. This allows for more coordinated, longitudinal care, especially for older adults and those with chronic illness. Leading virtual primary care programs also ensure that members’ records are available to all treating and referral providers, across specialties, to facilitate highly coordinated care. With more holistic member information in hand, providers can refer members to condition-specific programs and identify and close gaps in care.

3.) Provide whole-person healthcare. True care goes beyond the surface level, allowing the provider to understand the whole-person and the various factors that may impact a member’s social determinants of health. That’s one reason why a virtual primary care program must incorporate, extend and connect to other types of services and care programs, from diabetes and musculoskeletal management to behavioral health and second opinions to wellness and prenatal care. Since the pandemic began, telehealth has become more deeply embedded across the continuum of care, with a sharp year-over-year increase in adoption by physician specialists. Offering a tightly integrated virtual care experience expands opportunities for primary care providers to strengthen relationships across specialties. The ability to easily and digitally connect and enroll members in other types of services will also hold strong appeal for employers seeking an effective, integrated conduit to these services.

4.) Extend high performance networks, virtually. Today, 12% of member healthcare spending goes toward out-of-network care, driving up the cost of care. Virtual Primary Care can help reduce care costs for health plans by keeping members in network. Virtual Primary Care programs should include tools that make it easy for physicians to make in-network referrals, such as tabs that display preferred laboratories, formularies and in-network providers during members’ visits. This ensures members are referred to in-person follow-up care options that are convenient and affordable for them and result in less expense for the health plan.

5.) Leverage and incorporate remote patient monitoring devices to help members manage their health. Virtual Primary Care programs should provide consumers with automated tools and connected devices so they can manage chronic conditions more effectively from their home. These include digital apps that track and analyze health indicators as well as handheld, integrated devices that can look in the ear and listen to the heart.

The Future of Primary Care is Now

When done right, virtual primary care will not only allow health plans to keep members engaged, but also enable a healthier member population.

Danielle Russella is president of Strategic Partnerships at Amwell. She has over 25 years’ experience leading and growing innovative healthcare and technology companies, and successfully taking intricate solutions to market.