Wait times to see a physician have reached 56 days in mid-sized markets, according to a recent survey.
In large markets, the average wait time is 29 days, and these wait times have increased by at least 30 percent since 2014, leading to members relying on the emergency department or urgent care clinics for treatment, resulting in higher costs for the health system.
They’re more likely to seek treatment in emergency departments or urgent care clinics, even for acute symptoms that don’t require the level of intensity of service, resources, or cost attributed to these settings.
The result is a far higher cost to the health system, including out-of-pocket expenses for members and costs borne by health plans, for treatment that could have been provided at a lower cost in a physician’s office, highlighting the need for more accessible care options.
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Virtual health care services address this gap in the healthcare system by furnishing on-demand clinical care from high-quality, board-certified providers licensed in the same state as the member, and they include all of the elements of a traditional physician visit, including assessment of symptoms, examination, and treatment plans that include prescription drug management when warranted.
Members can access virtual health care 24 hours a day, 7 days a week at a fraction of the cost of urgent care or emergency room visits, making it a more convenient option.
Benefits for Health Plans
For health plans, virtual health care offers key benefits, including diverting members in need of acute, non-emergency care away from high-cost settings, and the on-demand nature of these services enables members to be more proactive in the overall management of their own care at a lower cost.
Unlike episodic visits in retail clinics, virtual health settings are better equipped to leverage clinical expertise to address more complex clinical cases, and they provide a more full approach to care.
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Phil Colmenares, MD, MPH, Senior Vice President and Chief Medical Officer for Premera Blue Cross, believes that the value proposition of covering virtual health care services for health plans isn’t only about reducing unnecessary utilization of emergency care services, but about offering convenient, virtual access to healthcare services as a benefit, including health care services that cater to specific needs.
Colmenares highlights the great potential for virtual care to offer high-quality specialty care at a lower cost, although it’s still an open question whether “first generation” acute care virtual health care services generate consistent cost savings, and many health plans are offering telehealth services today.
“Although not yet the case, it’s clear that in the future, virtual care delivery will become a competitive edge,” Colmenares says, and virtual health care services are becoming increasingly popular, with members showing a high satisfaction rate among those who try the service.
They provide a more convenient option.
