COVID-19 Boosted Virtual Health in Medicaid, but the Future could be Complicated | Deloitte US has been saved
By Scott Dillingham, senior manager, Deloitte Consulting LLP
The idea of using cell phones to engage with Medicaid members has been around for years—primarily as an adherence tool that helped them stick to care plans, remind them of upcoming appointments, or urge them to refill prescriptions. Using a phone or other virtual platform for clinical visits and care delivery takes this concept to the next level and could help Medicaid beneficiaries stay more connected to clinical teams. This technological lifeline also could help members more effectively manage medical conditions and avoid costly emergency room visits.
Virtual health can be a powerful tool for improving care coordination and care delivery in home-based settings. Our 2018 survey of US health care consumers found that most Medicaid beneficiaries have the technology and appetite needed to take advantage of digital health. However, it can be tactically more difficult to execute in the Medicaid population than in the commercial sector or Medicare Advantage (MA).
The COVID-19 pandemic pushed states across the country to relax rules around virtual health, which helped boost adoption among Medicaid members. About one-third of Medicaid members have had a virtual visit or consultation, and four out of five of those members are receptive to having another, according to Deloitte’s 2020 survey of US health care consumers, which was conducted prior to the lockdown.
The combined catalysts of policy modifications and necessity brought on by the pandemic seem to be having a profound impact on accelerating adoption trends. In one state, for example, the number of Medicaid recipients who used virtual care increased from 23,616 at the end of 2019 to nearly 200,000 as of June. During the same period, the number of providers in the state using telehealth jumped from 657 to nearly 16,000.1 Another state recently processed more than 1.1 million telehealth and 350,000 telephonic visits for its Medicaid members.2
Five challenges that impact virtual health adoption in Medicaid
Virtual health could support Medicaid members through care-management programs. An ongoing connection to a clinician—or care delivered in a home-based setting—could help people get their health conditions treated. However, engaging with Medicaid members has its own set of technology challenges and implementation nuances. Before COVID-19, virtual health in Medicaid was trailing adoption in commercial markets and MA. However, that gap appears to be closing, shedding light on the unique aspects of care delivery within this population. Here’s a look at five challenges that could affect the use of virtual health in Medicaid:
Medicaid provides health benefits to 97 million low-income Americans5 with the potential for significant growth as the impacts of COVID-19 continue to be felt and reverberate through communities. Opening new roads to meet them (and serve them where they are) can be critical, particularly during the pandemic. Cohesive approaches—including an appropriate virtual health infrastructure and lower-tech options along with operational, clinical, and engagement strategies—should be put in place. Virtual health has the potential to help maintain continuity and engagement with caregivers, provide a bridge and connection to social supports, and continue to advance opportunities for the efficient delivery of care in this vulnerable population. Deploying the right virtual health infrastructure and strategies can help ensure that Medicaid plans have the agility to react nimbly in a rapidly changing environment.
1. Telehealth use jumped in Medicaid system as pandemic swept Florida, News Service of Florida/News4 JAX, September 24, 2020
2. NC Medicaid Surpasses 1 Million Telehealth Visits Since Beginning of COVID-19 Pandemic, NC Dept. of Health and Human Services, October 1, 2020
3. National health care fraud and opioid takedown results in charges against 345 defendants responsible for more than $6 billion in alleged fraud losses
4. Why achieving health equity is so hard in the telehealth age, American Medical Association, October 21, 2020
5. Policy basics: Introduction to Medicaid, Center on Budget and Policy Priorities, April 14, 2020