The Advantages, Challenges of Introducing Virtual-First Health Plans
In their novelty, virtual-first health plans boast many potential benefits, but they also pose challenges that payers have to confront.
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- Although virtual-first health plans bring together tools that payers have been honing for years—apps, telehealth, virtual care, and more—the virtual-first model itself is still evolving.
To Donna O’Shea, MD, national chief medical officer and vice president of population health and value-based care at UnitedHealthcare, virtual-first health plans hinge on virtual primary care services.
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“There are a lot of terminology challenges in the virtual visit space. And so, when we talk about virtual first, we're talking about that primary care virtual experience, which is different than what virtual visits started with—their docket was about urgent care,” O’Shea explained.
Payers are attracted to virtual first health plans because they increase access to care and have the potential to improve the quality of care and patient experience. In addition to virtual primary care, virtual-first health plans often leverage concierge support and on-demand service to empower access to care and patient navigation.
O’Shea and the team at UnitedHealthcare should know. In October 2021, UnitedHealthcare announced its first virtual-first health plan, NavigateNOW. The virtual-first health plan is a collaborative effort between UnitedHealthcare and Optum’s virtual care medical group and it will be available to UnitedHealthcare’s employer-sponsored health plans across nine cities.
“We've learned, especially with the coronavirus pandemic, that patients need to be able to access services at different times and it has to fit into their life. And so, we want to make sure that we're providing that opportunity to the patient, but also linking it to ways that we can reduce unnecessary healthcare spending,” O’Shea shared.
Although there are various advantages to implementing a virtual-first health plan, payers have also had to confront challenges.
Namely, siloed care and disconnected technologies that do not talk to each other get in the way of providing high quality, coordinated care through the new model, O’Shea acknowledged. In virtual-first health plans, the virtual provider has to be able to refer a patient to in-person care and vice versa and records have to flow seamlessly between the two.
However, O’Shea shared how UnitedHealthcare has found its own way to navigate these challenges, as have its competitors who are also launching virtual-first health plans.
