MeMD

The pandemic has fundamentally changed the way Americans access healthcare. Today, telehealth has become an indispensable part of the nation’s healthcare system and a preferred means of accessing care – and its scope is expanding dramatically. Virtual primary care is the next and most important evolution. It cuts healthcare costs dramatically, boosts workforce productivity, supports retention and connects employees with important health services – all while meeting employees’ demands for ease, convenience, safety and quality. Anticipating the demand for virtual primary care, telehealth providers nationwide have rushed solutions to market. They all claim the same basic benefits, so how do you choose the right partner in this sea of sameness?

1. What services should my virtual primary care service include?
   

Your offering should provide access to all of the services you would expect from a brick-and mortar primary care provider – including routine labs, imaging and other in-person services – or it will not be a suitable replacement for traditional primary care. Instead, you may end up with a flimsy program that provides incomplete care and a considerable amount of hassle. You may also be stuck paying a monthly fee for access to telehealth providers – and paying out extra for services that can’t be handled via phone or computer.

At a minimum, your solution should offer the following virtual services:

• Annual wellness visit
  
• Routine follow-up appointments
  
• Ongoing management of chronic conditions such as asthma, diabetes and high blood pressure
  
• Prescription discounts
  
• Referral process that connects members with necessary specialists
  
• 24/7 urgent care for common illness and injuries 
  

Along with these in-person services (arranged on members’ behalf through partner labs and clinics): 

• Physical examinations 
  
• Routine vaccinations
  
• Routine screenings such as colonoscopies, cholesterol checks, prostate exams and urinalysis
  

2. How will the service offering cut healthcare costs?
   

Clear and Competitive Pricing: You want a partner that provides comprehensive primary care, a clear list of services and straightforward PEPM pricing so you can understand and anticipate the cost-savings.

Regular Reporting: Saving money is important – but how do you quantify the savings? Your partner should provide regular reporting that offers a clear look at how your company’s telehealth service is performing, from utilization across the workforce and redirection cost savings to overall ROI for the business.

Immediate Cost Savings: Virtual primary care visit fees are dramatically lower than traditional primary care, so businesses should save money every time an employee chooses telehealth over an in-person visit. Virtual primary care visits also won’t go against a company’s health claims, which will save money at renewal time. Plus, a telehealth partner can provide additional cost savings to the employer and employee alike via access to prescription discounts.

Savings Over Time: While not immediately measurable, primary care is directly linked to better health outcomes and lower costs over time. Providers can identify health problems early on and intervene before serious and costly issues arise. In addition, primary care providers play an important role in the management of patients with chronic diseases, improving outcomes for patients while also mitigating health expenditures. Five chronic diseases or risk factors – high blood pressure, diabetes, obesity, smoking and physical inactivity – cost U.S. businesses $36.4 billion a year because of employee absenteeism.

3. What does provider accessibility look like?
   

Choose a telehealth partner with highly qualified providers offering primary care expertise. Here’s what your partner should offer:

• Access to primary care providers nationwide, after hours and on weekends.
  
• Additional 24/7 access to urgent care providers for common illnesses and injuries.
  
• High patient satisfaction scores. 
  
• State-licensed board-certified providers who specialize internal medicine or family practice.
  
• Ongoing monitoring of patient outcomes and member satisfaction to ensure high-quality care.
  

4. Will my company’s employees use the service?
   

Telehealth utilization has soared during the pandemic, and all signs indicate that this care pathway will continue to grow in use and popularity. 

Pick a partner that will support your efforts to get staff on board with virtual primary care – because you won’t save money unless people use the program. Consider the following:

Ease of Use: Accessing virtual primary care should be simple, intuitive and user-friendly. Features to look for include: 

• Single sign-on experience to make it quick and easy to request a visit

• Coordinators to streamline the intake process and ensure technology is working properly

Availability Outside the Traditional Workday: A common complaint about in-person care is that offices are only open on weekdays, meaning employees have to take time out of the workday to see a doctor. A virtual primary care provider should offer appointments in the evenings and on weekends, too, allowing employees to access the care they need without major interruptions to their day.

Choosing a PCP: A bonus would be the option for employees to pick their virtual primary care provider vs. being assigned to the next available doctor. This additional value supports the continuity of care and enables patients to develop ongoing relationships with their provider of choice. A constructive, long-term relationship enhances overall care.

Care Navigation: In addition to increasing appointment accessibility, a telehealth partner should help members navigate the healthcare system and find appointments with specialists at a fair price near their homes or offices. Seek out a partner with a dedicated navigation team that takes the complexity and hassle out of scheduling a doctor’s appointment

Education: : Virtual primary care is only valuable if people use the service. A good partner will support your efforts to educate employees or members about the service and support enrollment efforts. They should provide marketing promotions and tools – customized for your organization – like email campaigns, web pages and other resources that make it easy for employees to get started with virtual primary care.

5. What administrative support can I expect?
   

You want a partner that will offer reliable and timely administrative support throughout the lifecycle of your relationship.

You should also take time to understand exactly what’s needed to get up and running with a new virtual primary care solution – and ensure your partner will make the process as simple and efficient as possible. The burden of implementing a new service often falls squarely on the shoulders of HR, but a good partner will ease that burden with a seamless and hassle-free experience, insurance connectivity with real-time benefit eligibility and deductible tracking.