Shift to virtual care can reduce claims by as much as 3%, study finds
This shift could result in annual cost savings of as much as $37 billion.
Supplementing traditional in-person health care with virtual care can reduce total medical claims spend by between 2.3% and 3.1%, according to a recent study by the technology platform Solera Health and machine-learning company Health at Scale. This shift could result in annual cost savings of as much as $37 billion to more than $50 billion, based on Centers for Medicare & Medicaid Services estimates of private insurer expenditures in 2022.
“In this analysis, we sought to understand the true potential of meaningful expansion of virtual care delivery across a broad set of conditions and at greater scale within the population,” said Dr. Byron Crowe, chief medical officer at Solera. “Our findings clearly highlight that there is an enormous opportunity to improve outcomes and reduce costs by offering patients virtual care earlier and more often in the care journey.”
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On-premise health care faces several well documented challenges, including physician and staff shortages; gaps in primary care access; geographic and other access barriers; and rising health care costs. Infrequent in-person visits make it difficult for patients to meaningfully affect their health trajectory. Claims data indicate that in many cases, this exacerbates a chronic condition until it becomes emergent, resulting in higher-cost interventions such as urgent care or emergency visits. Virtual care provides patients with more consistent access to care and more-frequent and lower-cost interventions, which lead to improved health outcomes.
“The analysis validates virtual health’s position within the health care ecosystem as a clinically and economically sound investment when implemented broadly across multiple conditions and specialties, providing an alternative when traditional care delivery has failed them, providing a whole new pathway to improve chronic health outcomes and to reduce the economic burden on payers and employers,” according to Solera. “Consistent, easily accessed virtual care can circumvent many access constraints (such as geography) faced by those attempting to receive traditional care, providing more efficacious, continuous, quality and timely care to those who need it most.”
A full published white paper reviewing the findings will be available at www.soleranetwork.com in November.