Virtual-First Insurance Plans On the Horizon?

Kaiser Health News released a report today examining the emergence of virtual-first health plans. The COVID-19 pandemic brought about an overnight adoption of telemedicine and virtual care.

On the patient side, health insurance costs have been rapidly accelerating, with higher premiums and deductibles placing an increased financial burden on families. Some insurers are beginning to offer lower-premium plans that have a catch: patients must see an online physician who will then refer to in-person, in-network visits if they are deemed necessary.

The online physicians conducting these screening visits, KHN reports, are largely contracted employees of virtual health firms such as Doctor on Demand. A number of these firms use a proprietary EMR system, raising concerns about coordination of care between virtual primary care physicians, brick-and-mortar offices, specialists, and hospital systems.

The prospect of lower premiums may entice some families to join these plans, but a careful reading of policy documents is necessary. Some virtual-first plans levy sizeable copays and deductibles for in-person care, even if those physicians are in-network.

There is great value in virtual care, as we witnessed during the early stages of the pandemic. In a busy and stressful world, being able to see a physician from home can encourage patients to seek out care when they may otherwise put off until a “later” that never comes, or comes too late.

Virtual-first plans that discourage in-person visits through financial leverage are something that may be cause for concern, however, and something we’ll be watching closely.

You can read more at the Kaiser Health News article here.