Posted: 19 Jun. 2019 7 min. read

Here’s how to make virtual health a pillar of your health plan members’ experience

By Felix Matthews, MD, MBA and Ken Abrams, MD, MBA, Deloitte Consulting LLP

Nearly all health plans (94 percent) offer virtual health services, and 96 percent expect their reliance on this technology will grow, according to the results of a survey conducted by America’s Health Insurance Plans (AHIP).1 However, despite being widely available, virtual health has generally not been embraced by health plan members. One of the most formidable barriers to adoption might be the members themselves.

According to the 2018 Deloitte Survey of US Health Care Consumers and Physicians, only 23 percent of consumers have experienced a virtual visit. Among those who have never had a virtual visit, just 57 percent said they are willing to try it.

Most health plans deliver virtual health via computers, mobile applications, and/or wearable devices. Common uses of virtual health include:

  • Facilitating patient access,
  • Improving care coordination,
  • Delivering disease-management services,
  • Promoting overall wellness,
  • Engaging with members, and
  • Enabling remote monitoring through wearable devices.

Health plans often partner with virtual health vendors to connect their members to a doctor—via phone or video—for low-acuity diagnoses, treatment, or to prescribe medication.2 Some health plans have also collaborated with vendors to offer virtual disease-management.3

Through vendor partnerships, health plans can provide care management via video chat and other mobile health applications, which use wearable technologies as a core platform. A mobile health application on a wearable device might use algorithms to analyze data from a heart-rate monitor and determine if the member has an elevated risk for atrial fibrillation. If such a risk is detected, the health plan might automatically send the member a free diagnostic test, or the member might be immediately directed to a local, in-network physician if needed.4

Many health plans are investing in wearable technologies to promote and motivate member wellness, and some health plans have started to collaborate with technology companies to create joint mobile health applications.5 These apps can help members establish goals, set sleep schedules, and stay on top of their wellbeing by sending reminders whenever a member is due for a check-up, flu shot, or prescription refill.

Five barriers (and solutions) that can limit adoption of virtual health

Here is a look at five common barriers that can limit adoption—and methods to help overcome them (as illustrated in the figure below).

Barriers to virtual health

Source: Deloitte analysis

1. Differing consumer preferences: A member’s willingness to adopt virtual health may reflect their demographics, comfort level with technology, and general health. For example, young, healthy, and tech-savvy members may be more likely than other members to download and regularly use a virtual health solution that promotes wellness. Some members might feel more comfortable with in-person visits and could respond negatively if they feel they are being pushed into virtual health by providers and/or health plans in a seemingly uncoordinated manner.

SolutionStrategically design and market, including to proxies: Health plans should consider strategically marketing their virtual health solutions by segmenting members (e.g., by age, health, etc.) to account for variability in member preferences and needs. Depending on the segment, plans may need to adjust their marketing and general messaging to resonate with members. For example, while it might be difficult to market a virtual health solution to a senior who is unwilling or unable to use it, health plans could strategically market to the adult children of seniors, who might be more tech-savvy. Health plans can also design their benefits and cost sharing structures to encourage members to use virtual health. A plan, for example, might have a $0 copayment for virtual primary care visits, but require a copay for in-person visits. Plans could offer free or discounted wearable devices as a benefit to encourage members to adopt virtual health.

2. Lack of trust in the health plan: When a health plan collects and virtually shares a member’s health data, the member might worry about the information being compromised, inaccurate (particularly data from wearable devices), or used against them in a way that could negatively impact their coverage now or in the future. Members might also be concerned that a virtual health solution could fail them in a time of crisis. Additionally, unexpected medical bills top the list of health care costs that frighten members,6 and, as a result, members may worry about using services that might not be not covered.

SolutionBuild trust with members: Health plans can use this technology to more effectively communicate with members and judiciously analyze experience patterns to create personalized interactions based on member needs and preferences. Some technology-focused health plans try to build trust when people first enroll in the plan by offering immediate access to a virtual concierge team (a nurse-led team that provides each member with personalized support whenever it is needed).7 Trust can also be built by offering hands on-support and coaching to demonstrate how to get the most out of the health plan’s virtual health care.

3. Inadequate member education: Some members might not understand how they can benefit from virtual health. Although awareness is increasing overall, 65 percent of the respondents to the AHIP survey say marketing and communicating their virtual health offerings can be challenging.8 Beyond awareness, health plans might also need to educate their members on how to use virtual health.

SolutionProvide ongoing member support: Health plans can help members grow more comfortable with virtual health by educating them on the benefits of the technology. Some health plans might already devote resources to the broader roll-out of virtual health, but they should also consider offering ongoing member support, tailored to each type of virtual care. The functionality and purpose of virtual visits differs from those of wearable technologies (e.g., wearables must be worn a certain way to be effective).

4. Technological and administrative barriers: Health plan members who are unfamiliar with technology might be less willing to use a wearable device—particularly if they don’t feel they have been properly trained on how to use apps and systems. Members who are hesitant to use video-conferencing or have connectivity issues may be less likely to adopt virtual visits. Moreover, cumbersome log-ins and passwords can make the adoption of virtual health solutions time-consuming. Members, for example, might be required to create multiple log-ins if their health plan uses multiple vendors or straddles multiple platforms. A member who has diabetes might have to connect with a care manager for one application and download another application to virtually interact with their diabetes disease manager.

SolutionImprove and consolidate user interfaces: Health plans should consider prioritizing the member experience when they begin to build or deploy a virtual health solution. Health plans should first consider implementing a unified, consolidated platform or hub where access to virtual health vendors, care managers, and disease managers is seamless. Consolidated solutions reduce the administrative burden of downloading multiple applications, signing up for multiple services, and remembering multiple log-ins and passwords.

5. Lack of employer engagement: About 75 percent of large firms that offer health insurance now cover telehealth services—up from 25 percent just three years ago, according to a recent survey from the Kaiser Family Foundation.9 Despite greater adoption of these solutions, a separate Kaiser study found that less than one percent of enrollees in large-group plans actually use their telehealth benefits.10 Health plans might have trouble educating employer groups on the benefits of the technology and what it is used for. Doing this well could help employers gain greater adoption among employees.

SolutionEnhance communication with employer groups: Health plans should consider providing employer groups with a menu of specific virtual health-enabled offerings (e.g., disease-management programs, care-management programs, member-engagement programs, wellness). The health plan should also consider succinctly messaging the value proposition of virtual health and clearly demonstrating how well each solution works. Employer groups can use this information to educate their members about the benefits of virtual health, which could help increase adoption.

To maximize the value of virtual health solutions, health plans should understand the obstacles hindering member adoption of these technologies. These obstacles can be overcome by taking a multi-faceted approach to virtual health that improves the rate of adoption and drives greater health and wellbeing for members.

If you are at AHIP this week, be sure to stop by Deloitte’s breakout session on Wednesday, June 19th at 11:45am CDT in Room 106!

Endnotes
1. Telehealth: Connecting consumers to care everywhere, AHIP, March 2019 (https://www.ahip.org/wp-content/uploads/IB_Telehealth-031219.pdf)
2. Teladoc (https://member.teladoc.com/aetna)
3. Bringing virtual care to life, Aetna, Inc. (https://www.aetnainternational.com/en/about-us/explore/future-health/virtual-health-care.html)
4. mHealth Intelligence, Oscar Health Uses mHealth to Improve Care Coordination for Members, April 2019 (https://mhealthintelligence.com/news/oscar-health-uses-mhealth-to-improve-care-coordination-for-members)
5. Aetna customers can get a free Apple Watch just for keeping close tabs on their health, Macworld, January 2019 (https://www.macworld.com/article/3336211/apple-aetna-attain-app-rewards.html)
6. Surprise Medical Bills Are What Americans Fear Most In Paying For Health Care, Kaiser Health News, September 2018 (https://khn.org/news/surprise-medical-bills-are-what-americans-fear-most-in-paying-for-health-care/)
7. How One Startup Built Better Health Insurance With the Magic, Wired, May 2017 (https://www.wired.com/2017/05/one-startup-built-better-health-insurance-magic-data/)
8. Health Plans Embrace Virtual Care for Improved Member Satisfaction, Cost Control, Teladoc Health, January 2019 (https://www.teladoc.com/blog/2019/01/22/health-plans-embrace-virtual-care-for-improved-member-satisfaction/)
9. 2018 Employer Health Benefits Survey, Kaiser Family Foundation, October 2018 (https://www.kff.org/health-costs/report/2018-employer-health-benefits-survey/)
10. More employers are paying for telemedicine, but enrollee take-up has been relatively low, Kaiser Family Foundation, October 2018 (https://www.healthsystemtracker.org/brief/more-employers-are-paying-for-telemedicine-but-enrollee-take-up-has-been-relatively-low/)

 

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Felix Matthews, MD, MBA

Felix Matthews, MD, MBA

Managing Director | Deloitte Consulting LLP

Dr. Matthews is a Managing Director and physician leader at Deloitte Consulting LLP. Felix is the National Lead for our Academic Health / Research Leaders practice. He advises his clients on strategies to succeed in an increasingly competitive market. His clients include academic health systems, national health plans, and life sciences companies. He is experienced in corporate strategy, care model innovation, physician engagement strategies, clinical affiliation strategy, value-based payments, operating model design, and digital strategy, among others. He also advises his clients on strategy implementation and enabling capabilities. With over 20 years combined experience in medical practice and health care consulting, Felix brings to his clients a unique blend of clinical understanding and business insight. Felix trained in trauma surgery and accident medicine and has led research focused on clinical technology innovation at major academic centers in the US and abroad. Felix is also a published author in peer-reviewed medical journals and a columnist on virtual health.

Ken Abrams, MD, MBA

Ken Abrams, MD, MBA

Managing Director- Chief Medical Officer

Dr. Abrams is a Managing Director in Deloitte’s Strategy Practice and Deloitte’s Chief Medical Officer. Ken is an anesthesiologist with over 30 years of experience as a practicing physician and physician executive in academic medical centers and integrated delivery systems. Dr. Abrams has market eminence as a physician leader and as a thought leader in clinical strategy, operations & performance improvement, virtual health, and clinical integration. Prior to joining Deloitte, Ken worked at Northwell Health (formerly North Shore LIJ Health System), where he served as senior vice president of Clinical Operations, chief quality officer, and associate chief medical officer for the health system. He has led multiple projects including a surgical services redesign, anesthesia department turnaround, and the 2010 National Quality Forum (NQF) National Healthcare Quality Award.  Prior to working at the Northwell Health, Ken was the patient safety officer and chairman of Anesthesiology at AtlantiCare. His achievements in his five years there included the creation of the Patient Safety Committee, a clinical transformation patient flow project and the creation of a critical care strategic development group, and a senior leader in pursuing AtlantiCare’s Baldrige National Quality Recognition. Prior to AtlantiCare, Ken spent almost 13 years at Mount Sinai Medical Center in New York as associate professor of Anesthesiology and medical director for Perioperative Services, among other roles. Ken holds a doctor of medicine (MD) degree from Sackler School of Medicine/Tel Aviv University, an MBA from Zicklin School of Business/Baruch College and a bachelor’s degree in biology from the University of Rhode Island. Ken also played Division 1 soccer while at URI and had the honor of playing on the U.S. Maccabiah soccer team, winning a silver medal. He lives in Florida with his wife, Mercy, and enjoys boating, tennis, and the outdoors.