Virtual primary care: A 4-step discussion framework for brokers
As an advisor for employer-sponsored health plans, it won’t be a question of if, but when, you will need to discuss VPC with your clients.
I have developed a four-step framework for discussing VPC with employers that will help effectively communicate the benefits of this exciting digital offering.
Step 1 – Gain common understanding about VPC
As with any relatively new advancement in health care, it is very important that everyone taking part in the discussion has a common understanding of what “it” is. The most common confusion around VPC I find is about how it differs from traditional telemedicine.
To me, traditional telemedicine is basically episodic, remote online urgent care. Aside from the occasional online consult with a doctor you know, telemedicine has been a point solution that sits outside the core health plan, distinct and disconnected from the patient’s primary care relationship.
Virtual primary care, on the other hand, shifts the long-term primary care relationship – including continuity and coordination of care and referrals – to a virtual realm. It’s the ongoing, trusted doctor-patient dynamic patients are accustomed to, from the comfort and convenience of home (or office, or hotel room or… you get the point). And the best VPC programs are fully integrated into the core plan and provider networks.
Step 2 – Address the ‘in-person’ care issue head on
Anticipate that a key question or objection from the client will be that most traditional primary care is considered “physical;” in other words, you can’t virtually hear someone’s heartbeat or peer into an ear canal. Certain situations will, of course, require hands-on, in-person care. But a virtual primary care visit can attend to a broad spectrum of services from preventive care and screenings to ongoing chronic care management, urgent care, skin evaluations, mental health care, prescriptions (with some limitations), and the list keeps growing. If needed, virtual primary care doctors can work with in-network specialists (who might be virtual or in-person) to guide members with complex needs to get the right diagnosis and treatment.
And remind the client of the present and future of technological developments and other in-home medical advances that seem to come to market almost every day. These breakthroughs can usually be synced up with VPC quite easily. I am certain that technologies surrounding primary care procedures that can be incorporated into a well-run VPC practice will rise rapidly.
Step 3 – Remind the client of the medical homelessness crisis in America
No HR or benefits leader paying any kind of attention to health care is going to argue about the well-documented and mounting evidence that primary care leads to healthier outcomes and lower total cost of care. Yet according to a Kaiser Family Foundation study, one-fourth of all adults and nearly half of adults under 30 do not have a primary care doctor. And the stats are worse among minority groups. Since so many workers are in wide-open, uncoordinated PPO networks, there is a high probability a large percentage of your clients’ employees do not have a PCP to call their own.
A well-run VPC capability inside an employer’s health plan addresses this issue head on, as it offers an extremely convenient, easy-to-use platform. Given that people of all ages became much more comfortable with virtual physician interaction during COVID, VPC has the power to dramatically increase primary care doctor selection and relationship-building.
Here’s another best practice: Use VPC as a type of auto-enrollment tool, a la 401(k) plans, which can be opted out of at any time. My bet? Many of these auto-enrollees will love the VPC experience.
Step 4 – Highlight the cost savings and efficiencies VPC can bring
Now that you have the client intrigued, bring the discussion home by touching on the potential savings and efficiency gains VPC can bring for self-funded health plans. With a virtual and accessible PCP, patients are directed to the right level of care when and where appropriate. And that’s a game changer, because a recent Cigna study showed that virtual care can reduce unnecessary ER and urgent care visits by 19 percent. We all know how impactful that can be on cost reduction just by looking at your own clients’ claims data tied to ER and urgent care visits.
Then point out all the “softer” benefits of a strong VPC capability that can have a powerful impact on workforce productivity and efficiency:
- Flexible scheduling to fit work and family commitments
- No travel involved, decreasing absences and expenses while eliminating any barriers of distance
- Reduced wait times for visits – and no physical waiting room
- Fewer gaps in care, especially for managing chronic conditions
These soft benefits are also real stress reducers for workers who, due to COVID and other issues, are often at the mental health breaking point.
By utilizing the four-step discussion framework above, you can have a productive and positive conversation with your clients about the possibilities of integrating VPC into their core health plan benefit offering.
Wayne Jenkins, MD, MPH is Chief Medical Officer at Centivo.