Virtual Care Technology Focuses on Prevention

Additional Trends to Expect in 2023:  Technology + Innovation Supports the Virtual Care Industry

Part 2 of 2

by Michael Gorton

The virtual care industry is on a mission: to enable patients, providers and payers throughout the healthcare ecosystem to make smarter decisions about utilizing digital technology and virtual care solutions to improve access to care that results in better outcomes at lower costs. This change is especially important for brokers as they continue to advise clients about selecting the highest quality organizations for serving employer workforces. Part II of this series captures additional key trends in virtual care that will impact brokers in their   processes to make the best recommendations 2023:  

Continued Shift to “Virtual-First”

Analysts confirm that virtual care use has stabilized at levels 38 times higher than before the pandemic: 40% of individuals believe they will continue to use virtual care going forward and 40–60% of individuals express interest in a broader set of virtual care solutions such as virtual-first health plans. 

a) Anticipate rapid expansion of virtual care to dramatically reshape how healthcare is delivered, with trends showing that it’s no longer enough for virtual care to provide individuals with a convenient way to access care for acute conditions. 

 b) As the COVID-19 pandemic accelerated, the healthcare system strained to respond appropriately. The dilemma for private practices was less about emergency care and more about how to continue providing services for patients when clinic doors were suddenly closed to in-person routine visits. 

 c)  New research from providers illuminates bright spots and areas for improvement that make telemedicine attractive, productive and profitable for both providers and patients. They report that 15% of all visits were done virtually, 89% of patient feedback was positive and 76% of patients would recommend telemedicine and to a friend.

 d) Among more traditional healthcare organizations, leading analysts believe we will see a focus on optimizing virtual care delivery models, enabling enhanced access to virtual care and building up the underlying infrastructure. 

 e)  Expect to see even more innovation in how those providers are accessing virtual care, integrating it into their care models and integrating it with value-based care models. In this environment, two types of virtual care model archetypes are emerging: a model will focus on specific conditions or offerings and be direct-to-consumer; and another will be an integrated hybrid care focused on chronic, primary, and behavioral healthcare services.

Additional industry guidance says that while the direct-to-consumer space will remain popular for smaller players, larger organizations will move toward centralization. They predict that all the big health plans and health systems are going to centralize their telehealth investments with emerging technologies coming from the tech vendors and perhaps, the leading retailers. Solidifying the medical cost value of telehealth services will be a primary focus to demonstrate that these solutions are actually reducing the consumption of acute care services or replacing them with telehealth services rather than adding on more line-item costs.

As employers become more reliant upon brokers for credible, trusted advice, these industry data points can be woven into the suggestions that brokers make in order to further build client relationships.  Self-insured companies are continuously searching for opportunities to improve employee health outcomes, enhance the member experience and lower the total cost of care. This is particularly important for employer direct contracts with providers where quality and cost are the arbiters for decision-making.

Healthcare transitions to the home 

Better telemedicine solutions are giving healthcare organizations a greater competitive advantage in a highly saturated market. The telehealth industry is quickly becoming a quarter-trillion-dollar sector, with some of this revenue that was once attributed to utilization at acute facilities now moving toward healthcare in the home. 

Leading analysts point out:

a) when patients enter a healthcare facility, their primary aims are to become well again and to go home. While increasing disease burden and rising healthcare costs in the United States have already contributed to a boost in Care at Home services, the COVID-19 pandemic has created a catalyst to truly reimagine their future.

b) Based on a survey of physicians who serve predominantly Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, it is estimated that up to $265 billion worth of care services (representing up to 25 percent of the total cost of care) for Medicare FFS and MA beneficiaries could shift from traditional facilities to the home by 2025 without a reduction in quality or access.

c) Emergence of new technologies and capabilities are making care at home possible for more people. Remote patient-monitoring devices, for example, allow providers to monitor patient progress remotely and receive alerts if there is an issue. In an April 2021 poll, more than one in five healthcare leaders said that their practice offers remote patient monitoring. Stakeholders are exploring ways to provide higher-quality care, especially for an aging population, including home-based services that include primary-care visits via telehealth, self-administered dialysis at home, and skilled nursing-facility services at home with remote patient monitoring and support for activities of daily living. 

To better serve their clients, brokers should be cognizant and knowledgeable of this shift to “Care at Home,” a trend that creates value for employers and their workforces.   Empowered with this knowledge base, brokers can better assess the capabilities of healthcare facilities,  physician groups, home care providers and technology companies to meet payer expectations.   It also could improve patients’ quality of care and experience.

Growth in Virtual Care is Palpable

In February 2021, the use of telehealth was 38 times higher than pre-pandemic levels and some estimates predict that 70.6 million Americans will use remote patient monitoring tools by 2025. About 40 percent of surveyed consumers said that they expect to continue using telehealth going forward. This represents an increase from 11 percent of consumers using telehealth prior to the COVID-19 pandemic.  Integrated digital solutions are likely to shed their focus on siloed, add-on telehealth or remote monitoring solutions that mirror the fragmentation and unreliable care transitions of our existing system.

Patients with post-acute and long-term care needs will be evaluating their options. As baby boomers age and families contend with the ongoing impact of the COVID-19 crisis, a growing number of patients and families may be considering their options for post-acute and long-term care. Ideally, eligible individuals would receive care in the most appropriate setting, whether that is at home or in a facility for rehabilitation, assisted living, skilled nursing, or long-term care. A combination of remote monitoring, telehealth, social supports, and home modification may enable more patients to receive some level of Care at Home. 

Greater Focus on Care Coordination

Telehealth has the potential to improve transitions of care, through enhanced connections among patients and their clinicians, during a vulnerable period such as after hospital discharge. To achieve triple aim objectives, reducing unnecessary hospital readmissions is desirable for payers and patients alike. 

Several key studies have shown the values of telehealth in reducing avoidable hospital readmissions. Telehealth interventions using primarily communications and surveillance technologies show the most promise in counseling and enhancing patient compliance with treatment and the patient’s transition to the home while managing multi-comorbid diseases.

Thoughtful industry stakeholders will increasingly implement an integrated digital technology approach that supports every step and every transition in the care journey, creating the connective tissue that makes patient-centered, team-based care a reality.

At the nexus of employer healthcare benefits decision-making, brokers are well positioned to not only be aware of the digital/virtual trends, but also knowledgeable about the industry players that have a track record for meeting company expectations.

Convenience Factor Drives Increased Consumer Preference for At-Home Lab and Genomic Testing 

Stakeholders that may have the greatest say in how quickly home testing becomes common is patients themselves. They value the convenience of taking a test at home and receiving the results digitally afterwards. 

While at-home lab testing has been available for decades, it is now clearly on the rise and these tests have become increasingly utilized during and following the COVID-19 pandemic.  The issues of quality, access and cost-savings inherent to at-home lab testing should send an important signal to brokers who may be tasked to evaluate these options.

The notable increase in at-home testing may be attributed, in part, to the widespread availability of COVID-19 tests, school and employer-mandated testing, and the desire to avoid exposure to the coronavirus. An April 2022 report from a trusted source at the CDC suggests that at-home COVID-19 test use peaked in January 2022, with 11% of the surveyed population reporting at-home test use within the previous 30 days.

According to a February 2022 report, the at-home test industry is projected to be worth over $2 billion by 2025. Moreover, a recent market research analysis suggests that the global at-home testing kits market will grow at a compound annual growth rate (CAGR) of 6.1% from 2022 to 2029.

An estimated 26 million consumers have sent DNA samples to the four leading commercial ancestry and health databases to decode any mysteries in their genetic pool. Patients also prefer to conduct other tests at home, such as Cologuard or rapid oral HIV testing. In a study based in San Diego, California, 62% of survey participants selected home as their preferred location for a rapid HIV test.

Higher Utilization of Telehealth Advances Health Equity

Access to quality, affordable health care is a fundamental human right, regardless of patient location, economic status or race. The American Medical Association says telehealth has the potential to become an important tool to address longstanding health inequities in the historically marginalized racial and ethnic groups that have been disproportionately affected by the COVID-19 pandemic. 

The World Economic Forum asserts that virtual care technologies, such as telehealth, have the potential to significantly improve global health equity. They forecast the ultimate result of this predictive and personalized healthcare will be earlier medical interventions that prevent medical crises and lead to better outcomes across countries of all sizes, locations and stages of economic development. 

Next-generation technologies, such as remote patient monitoring and management, which include real-time and continuous data collection and analysis from medical-grade biosensors worn in the home, enable clinicians across the globe to address the health inequities and social determinants of health in ways never before possible.

Achieving health equity is quickly becoming a priority for many employer groups, and brokers are well-advised to learn how they can help their clients advance this step forward. 

Telehealth increasingly serves all age groups and demographics

About a third of older Americans say they plan to use telemedicine in the future, a number that has remained steady throughout the pandemic, according to a new AARP study. Thirty-two percent of adults 50 and older said they were extremely or very interested in utilizing telehealth services for themselves or a loved one, the poll of 1,149 older adults found. 

Women and non-Hispanic Blacks were the groups most likely to express a keen interest. More than half (51 percent) of older adults said they or a family member had used telemedicine during the past two years, with women being more likely to have done so than men. The report concluded that telehealth is likely to continue to remain an important tool in the health care delivery tool kit — at least for those with computers and high-speed internet access.

Behavioral telehealth provides a safety net for millions of parents that have been faced with skyrocketing rates of mental and behavioral health issues among their adolescents and teens. Pre-COVID, 12.8 million children between 3 and 17 years old had been diagnosed with anxiety disorder, depressive disorder, and ADD or ADHD, according to the Kaiser Family Foundation. A growing problem before, COVID wreaked havoc on an already vulnerable group and behavioral telehealth offers immediate support.

Michael Gorton is a quintessential entrepreneur and company builder. As CEO of Recuro Health he leads a team which includes several leaders from Teladoc, where he served as the founding CEO and pioneered an industry-changing health care model that created a new efficiency paradigm in healthcare.