By Tony Abraham, Healthcare DIVE | May 16, 2019

Dive Brief:

  • Health plans have been quick to embrace virtual care, but a new survey from America’s Health Insurance Plans shows most patients aren’t showing the same enthusiasm for the technology in a clinical setting. Commercial, managed Medicaid and Medicare Advantage plans each reported difficulties with patient engagement.
  • According to AHIP, the majority of commercial (94%), MA (92%) and managed Medicaid (88%) plans are currently selling some form of virtual health benefit.
  • Patients haven’t been quick to buy in. The majority of commercial (87%) and Medicaid managed care plans (91%) said patient engagement is a “key challenge” to full adoption.

Dive Insight:

Whether it’s the potential for using augmented reality in surgery or simply a video conference with a primary care doctor, virtual care remains wildly popular among payers. Patients may be skeptical, but payers aren’t alone in their confidence. CMS has steadily given MA plans room to experiment with the technology.

Regulatory hurdles have long been a dealbreaker for payers and virtual health. Those challenges still linger, even for MA plans. Insurers in that segment said it’s their biggest barrier to entry, as states have been much more rigid on the virtual care front than CMS.

Concerns still linger, even among industry leaders who, as recently as February, expressed concern over how telehealth and virtual care platforms might affect clinical workflow. But an American Well study from last month found physician adoption of telehealth jumped 340% between 2015 and 2018.

Still, most Americans aren’t entirely familiar with telehealth. As recently as 2018, only 20% reported receiving such care, according to Accenture. About 70% expressed interest in receiving it.

But most of the healthcare industry, from provider groups like the American Hospital Association to Haven CEO Atul Gawande, see disruptive potential in the technology.

Payers share that enthusiasm, and many have begun rolling virtual health out to specialties. Humana had some early payment successes with telebehavioral health in 2018, and according to AHIP, commercial, managed Medicaid and MA plans, have all found a sweet spot with behavioral health, and are beginning to get their footing in non-emergency acute care settings.

Every payer has reported “increased access, improved health outcomes, increased patient satisfaction, and more coordinated care management” among beneficiaries who received virtual care, according to AHIP. Although those areas may be improving, the group said there is still progress to be made in getting patients engaged in and accustomed to virtual health services.