Virtual care moves toward the frontline of provider-patient relationships

Kaiser Permanente and UnitedHealthcare are using telehealth for primary care visits and quick patient consultations.

Les Masterson

May 3, 2018

Virtual care, once on the fringes for providers and patients alike, is becoming more of a reality, and is increasingly used for low-acuity needs.

Kaiser Permanente and UnitedHealthcare are among the big names using such settings for primary care appointments and quick patient consultations.

Backers of virtual care say it holds potential to improve quality, cut costs and improve accessibility to specialty services.  

“Virtual care has great promise," said David Harlow, principal at a healthcare law and consulting company and author of HealthBlawg. Still, he warned against over-reliance.

"It is not a panacea. We need a different system-level mindset to achieve long-term improvements in outcome and reductions in cost,” Harlow told Healthcare Dive.

And it's not like an episode of “The Jetsons” either. It doesn't replace in-person healthcare. Instead, virtual care integrates video, phone, email and messaging into a person’s healthcare.

Providers are selling the idea as a means of convenience and efficiency:  Patients might not have to take off work, find a babysitter and drive to an appointment. Instead, virtual care lets patients decide — when clinically appropriate — whether an in-person visit is necessary.

Patients seem to like the idea even if they haven’t tried it yet.

A recent Accenture report said about 70% of consumers are interested in virtual healthcare. Only 20% have actually received such care. “Virtual care offers what consumers really want: a variety of health and care service available to any location at any time, crossing the spectrum from health and wellness to episodic injury and illness to ongoing condition management,” the report said.

The shift may be sped up amid the shift from volume to value in payment models. Virtual care can become part of value-based care if there isn't a worry for providers about not getting paid for a virtual visit, the case now in a fee-for-service payment system.

More than half of Kaiser Permanente's patient visits are virtual care

Some health systems are already putting virtual care at the forefront. Kaiser has grown virtual care to slightly more than half of their more than 100 million patient encounters.  

One benefit KP has over other health systems is that it’s integrated and offers physicians capitation. Providers are paid a monthly member fee to care for the whole patient. That helps Kaiser by avoiding potential payer/provider issues involving insurers paying physicians for volume. About 95% of its more than 12 million members are covered through a capitated payment system.

That makes engaging physicians less of a challenge than it might be for providers reimbursed by volume.

KP offers non-emergency consultations via video behind a VPN firewall, secure email, messaging and telephone. Patients can have virtual visits for non-emergency urgent care, and routine and follow-up care with primary care and specialists, including in the areas of dermatology, mental health and podiatry.

Pat Conolly, executive vice president of information technology and chief information officer at The Permanente Federation, told Healthcare Dive that the type of virtual care, whether video or phone, that is most popular varies by area.

In Hawaii, where a body of water may separate patients from doctors on another island, telephone appointments are especially popular.

https://www.healthcaredive.com/news/virtual-care-moves-toward-the-frontline-of-provider-patient-relationships/516025/