At the height of the COVID-19 pandemic, employers believed virtual care would have a huge, broad impact on how care is provided across the country.
However, as the virus has receded, their confidence in the likelihood of this widespread change has waned, according to a newly released survey from the Business Group on Health. The organization released its annual look at large firms' priorities and concerns about healthcare on Tuesday, polling 152 large firms representing 19 million workers between June 1 and July 18.
In 2019, just over half (52%) of large employers said they believed virtual services would have major impacts on care delivery. Thanks to the pandemic, that jumped to 80% in 2020 and 85% in 2021.
The number then declined to 74% in 2022 and further to 65% this year, according to the survey.
Brenna Shebel, vice president of the Business Group, said there was "a lot of optimism during COVID" around the potential for virtual care as patients avoided in-person visits.
"This decrease that we saw is not incredibly surprising," she said during a briefing with reporters on Tuesday.
Employers noted a number of concerns around virtual care, according to the survey. A majority (70%) said they were worried that these platforms were siloed from other sites of care, which could hinder coordination for members. In addition, 54% said they were concerned about the quality of care offered from virtual providers.
Overall, the surveyed employers flagged many of the same potential issues as they had in last year's survey. However, for 2023, the number saying there were too many solutions on the market grew substantially, rising to 43% from 26% in 2022.
Shebel said that if coordination is poor, that could lead to worse outcomes for the member as well as a more negative experience.
"This begs the question, 'Is this really impacting the quality of care?'" she said. "How does this change the healthcare experience?"
Employers also expressed interest in streamlining their vendor partnerships to ensure they're effectively aligned and are actively seeking proposals and other evaluations to achieve this goal, according to the survey.
The survey found that 38% of employers are planning to make changes to the vendors they contract with beyond their health plan or pharmacy benefit manager. Nineteen percent said they intended to make changes to their health plan, and 9% said they planned to make changes to their PBMs.
Employers want to see greater transparency into their costs and outcomes, said Ellen Kelsay, CEO of the Business Group, during the briefing. Consolidating and streamlining the experience enables employers to find "where they can drive greater value from the partners they do choose," she said.