Among the biggest changes that could come out of the massive shift in telehealth use during the pandemic? Payers will increasingly encourage "virtual first" healthcare.
That was the consensus among telehealth experts during a recent Fierce Health IT virtual event, Telehealth's Takeover.
"This is where we have to go. We owe it to ourselves," said Ian Tong, M.D., chief medical officer of telehealth company Doctor On Demand. "Especially given the disruption that we’ve seen with COVID, we’ve been given an opportunity to see what virtual care can do and what these virtual first plans can do."
In 2019, Humana teamed up with Doctor On Demand to launch a new virtual first primary care model called On Hand that gives patients access to a dedicated primary care physician as well as access to preventive care, urgent care and behavioral health care through video visits with lower monthly premiums.
Earlier this year, integrated health giant Kaiser Permanente announced the launch of a virtual first health plan in Washington state. The idea, it said, is to make telehealth the backbone of care delivery while offering an option for patients to get in-person follow-up visits, if necessary.
"I think we should be experimenting with them," Tong said. "[The Centers for Medicare & Medicaid Services (CMS)] should certainly sponsor some programs and do the testing and the modeling with [the Center for Medicare and Medicaid Innovation]. They should look at the data they now have thanks to COVID and say, ‘What does phone do? What does [asynchronous telemedicine] do? What do video visits do?' I think they are going to find that all of telemedicine is not the same thing."
He pointed to guidance coming out from industry groups making recommendations to CMS regarding which telehealth visits should be on parity with brick-and-mortar visits and which shouldn't.
"My point just there is there’s a ton of data we now have. We should look at it and promote and push forward. I think CMS would agree. They came out and said telemedicine is here to say," Tong said. "But now they need to get Congress to act to make sure that’s the case."
Meanwhile, Amwell is preparing to launch its own partnerships with health plans, said Peter Antall, M.D., chief medical officer of the telehealth company.
“This is the future. We are the technology that sponsors a very large program in Israel where it’s digital first," Antall said. "You go digital before you can go to the emergency department or urgent care center. There’s so much more we can be doing with chronic disease and wellness."
Beyond virtual first, COVID-19 has demonstrated the importance of ongoing virtual monitoring, said Dana Udall, chief clinical officer for Ginger, a digital mental health company.
“The medical monitoring remotely is hugely important for mental health. We can treat things like eating disorders remotely, substance use disorders. That is sort of unthinkable that we can do this kind of work and really treat the majority of folks online," Udall said. "I think this is really the way to go and I don’t see that changing anytime soon."