Electronic Health Reporter

By Shriya Palekar, AVP Health Plan Solutions, TytoCare.

The COVID-19 outbreak led many to realize the transformative value the virtual world can bring to their industries. The healthcare industry – where virtual care and telehealth integration are becoming more and more accepted – is no exception. 

In fact, telehealth utilization rates have stabilized, ranging from 13% to 17% of total care visits across all specialties in 2021, compared to pre-pandemic levels – an upward trend that has continued in 2022.

These spikes, however, do not guarantee that virtual care will become universally accepted, especially when it comes to primary and routine care that go beyond on-demand needs. Many health plan members are used to in-person appointments for these types of care, and 53% of people still prefer an in-person visit for a non-emergency health issue, assuming out-of-pocket costs are not a factor.    

Given this reluctance, the question remains: how can health plans boost adoption rates of virtual primary and urgent care for the benefit of both members and the overall healthcare system? 

When looking beyond urgent and acute medical services, there are still barriers to virtual care adoption that need to be addressed. The path to increased virtual care adoption for routine care lies in differentiating unique segments of members and understanding their needs individually. Health plans and healthcare systems need to engage their members by understanding who they are and by breaking them down into clear population segments to reveal their unique needs, and understand how best to personally incentivize these groups to buy-in to the world of virtual and hybrid care.  

The Young and Healthy

This segment of the population includes Gen Z and millennials who don’t typically have the need for consistent care, meaning they usually have infrequent interactions with primary healthcare providers. In fact, according to surveys, only 33% of millennials and only 40% of Gen Z see their primary care physician annually. Virtual care can be a great way to encourage more frequent checkups among these cohorts, especially considering that virtual care has the added benefit of offering an on-demand digital solution that these digital-native members are accustomed to.

For the young and healthy population, engagement is most successful when it clearly communicates how virtual care works, how long a visit takes, and when the virtual visit will provide monetary incentives, since symptomatic relief is usually not a powerful enough driver during that stage of life.

Members with Dependents at Home

Sometimes referred to as the ‘sandwich generation,’ this segment includes adults with a parent aged 65 or older who are either raising at least one child younger than 18 or providing financial support to one that is older. As opposed to the younger generations, they tend to have more stringent routines and require more long-term health care assistance.

Hybrid models of care are crucial for these in-family caregivers to help alleviate the strain of providing care, which they do for 24 hours per week, on average. Health plans and healthcare systems can gradually onboard adults in this segment by incentivizing a digital-first or hybrid model that balances virtual care with in-person visits. To enhance the likelihood of adoption, they can build in incentives such as copay waivers and differentiated out-of-pocket pricing for episodes of care that start with a virtual visit.

Longitudinal and Chronic Care

60% of American adults suffer from a chronic disease, and 40% suffer from at least two. As a result, this group engages in the lion’s share of in-person healthcare interactions, with 61% of emergency department visits in the US from someone with at least one chronic condition. Thus, this group has the most to gain from virtual care. Here, virtual care can drastically reduce the time members devote to routine appointments and lead to better outcomes due to more convenient access to necessary check-ins, and more comprehensive monitoring. 

The incentive for this group lies in the benefits of virtual care at large – time savings, better care navigation, and improved care. Adoption will depend on clear communication and reassurance about the coordination and hand-offs between virtual and in-person care pathways.  

Routes to Wellness

There’s no fast lane to mass virtual and hybrid care adoption. But personalizing incentive strategies that fit the needs and top-of-mind concerns of specific members offers up multiple routes to that desired destination.

Blending personalization and navigable high-quality care is the key to delivering positive outcomes such as improved health, but also member satisfaction – both of which are essential for winning people over to virtual care, for the benefit of the entire healthcare ecosystem.