In the ever-evolving healthcare landscape, it is widely acknowledged that the health plan industry needs an overhaul. While employers and brokers may differ on the precise path to change, the recent Employer-Broker Health Plan Trends Survey conducted by Centivo highlighted the potential for innovative ideas and the critical role of primary care. The full article provides insight into improving healthcare accessibility, reducing costs, and addressing barriers to care. By embracing this evolving model, employers and brokers can foster positive change in the healthcare system.
The survey revealed a consensus among employers (95%) and brokers (94%) on the vital role of primary care in enhancing health outcomes and controlling costs. However, the current state of primary care in the United States is cause for concern. With primary care spending accounting for less than 5% across commercial payers and a significant portion of insured individuals lacking a usual source of primary care, there is a pressing need for improvement. High out-of-pocket costs, particularly with high-deductible health plans, often deter individuals from seeking routine primary care, leading to more serious and costly healthcare issues down the line.
Virtual primary care, also known as virtual-first or digital-first care, presents an opportunity to address the challenges faced by traditional primary care models. By eliminating barriers related to geography, physical presence, and scheduling, virtual primary care ensures accessibility and convenience for patients. This model proves especially valuable in bringing care-avoidant individuals back into the healthcare system, reducing the reliance on emergency rooms for primary care needs.
Embedding virtual primary care within health plan offerings can provide an attractive option for plan members seeking the flexibility of virtual visits while maintaining a strong primary care relationship. Patients can easily coordinate in-person or specialty care with trusted in-network doctors by developing rapport with their virtual care team. Employers can explore a range of options and features when considering the integration of virtual primary care, from on-demand visits to fully integrated practices within employer-sponsored health plans.
While employers are open to the idea of virtual primary care, the survey revealed some hesitation when it comes to a complete transition. Only slightly over half of employers would consider a health plan solely reliant on virtual primary care. However, employers can find solace in virtual primary care doctors collaborating with in-network specialists, both virtual and in-person, to provide comprehensive care as needed. This flexible approach allows employers to explore various virtual primary care practices and find the right fit for their workforce.
The evolution and acceptance of virtual primary care hold great potential for transforming the healthcare system. Employers and brokers can drive positive change by encouraging open dialogue and embracing healthcare innovation. The affordability and accessibility offered by virtual primary care can improve health outcomes, reduce costs, and ensure individuals receive the right care at the right time.
In an industry, ripe for change, virtual primary care emerges as a promising solution for the health plan industry overhaul. With overwhelming support for primary care and an increasing interest in virtual care, employers and brokers must engage in open dialogues to foster innovation and momentum. By embracing virtual primary care as a component of health plans, employers can enhance the accessibility and affordability of care, while brokers can address their concerns regarding implementation. Together, they can pave the way for a more patient-centered, cost-effective, and sustainable healthcare system.
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