🔒CT insurers roll out virtual primary care plans as telehealth becomes mainstream

The global pandemic forced healthcare providers to adopt virtual care almost overnight, bringing to the mainstream a service previously used by only a small percentage of people.

But now telehealth is becoming a normal and important part of the healthcare delivery system, partly because employers are demanding it.

The best evidence of that is the recent or planned roll out by Connecticut insurers — including Harvard Pilgrim Health Care, Anthem, Aetna, Cigna and UnitedHealthcare — of virtual primary care plans, which aim to provide greater and quicker access to physicians at a lower cost.

The first to offer virtual primary care coverage in the state was Harvard Pilgrim, which rolled out its plan in January to more than 1,000 local employers representing about 25,000 members.

Harvard Pilgrim teamed up with Doctor on Demand to launch the plan, which gives members access to primary care physicians through video, voice and in-app messaging 24/7.

Services offered include preventive and behavioral health, chronic care management and urgent care.

Paul Bartosic, Harvard Pilgrim’s Connecticut market vice president, said his company was planning to branch out into the virtual world prior to the pandemic.

“Certainly, we believed there would be a trend over time when telemedicine would be more widely accepted,” Bartosic said. “We had plans to roll out before the pandemic, but the pandemic did expedite the comfort level people have with telemedicine.”

From Feb. 2020 to April 2020, the height of pandemic-related shutdowns, Harvard Pilgrim’s Connecticut members increased their use of telehealth services by 6,148%.

Bottom-line impact

One of the attractions of virtual care plans is the cost savings, particularly for employers.

Figures vary, but employers that adopt virtual primary care coverage can typically see a savings of about 8% compared to a traditional plan, Bartosic said. Those savings can be passed on to employees — an attractive benefit amid a tight labor market.

UnitedHealthCare is introducing their virtual primary care capability during the first quarter of 2022 in Connecticut, but it's not clear when NavigateNOW, the company's virtual-first medical plan, will launch in Connecticut.

Donna O’Shea, UnitedHealthcare’s chief medical officer of population health management, said adoption of that service by employers lowers plan premiums by 15%.

Savings, insurers said, are due to a combination of factors. For example, virtual care leads to fewer people visiting costlier settings like an emergency room. It also leads to more people using primary care, which can prevent more costly healthcare problems in the future.

So far during 2021, UnitedHealthcare members nationally have completed more than 21 million virtual care appointments, up 2,500% from the comparable period before the COVID-19 pandemic started, O’Shea said.

Telehealth also makes it easier for people to get care they need quicker, insurers say.

Jill Dailey, vice president, Aetna, commercial product, said the Hartford insurer introduced its virtual primary care service in all 50 states in August.

“This nationwide service re-imagines the primary care experience and makes it easier for people to get the health services they need, anytime, anywhere,” Dailey said. “For example, in addition to primary care visits with a board-certified physician, members have access to a virtual nurse care team through unlimited in-app text or phone for pre-, during and post-visit support, including navigation to in-person, local providers as well as labs and testing.”

More access

Healthcare brokers and other experts say the early diagnosis is that telehealth has many more advantages than disadvantages and is here for the long term.

“Virtual health and telehealth is certainly on the top of the mind of our clients and with administrators,” said John Giliberto, a broker and partner specializing in health care with Alera Group Inc. “It creates more access, but the jury is still out on the impact it’s had. Employers are asking for this. I don’t have any clients now that do not have some component of telehealth in their plan.”

While in-person visits for things like mammograms, blood draws and X-rays are a must, virtual care is an option for a wide range of services including medication and chronic conditions management and mental health.

In many cases, the wait time for patients to see a primary care physician is dramatically reduced.

Aetna said the typical wait time to visit a new physician in-person is about 24 days vs. five days to see a doctor virtually.

Virtual mental health is also gaining traction because it expands access and lessens the time it takes to schedule an appointment.

In fact, UnitedHealthcare said that 68% of behavioral health visits by its members during the last year have been conducted virtually.

“Mental health was a lower utilized service that people were not willing to talk about because of the stigma. That is starting to change,” Giliberto said. “Employers are now promoting mental health services and support. Telehealth can really help on the mental health side. It does not have to just be a phone call, but it can be Zoom time or Facetime.”