Anthem Offers Virtual Care Platform To Facilitate Second Opinions

Anthem has partnered with The Clinic by Cleveland Clinic to improve members’ access to second opinions on their healthcare needs, Anthem revealed in a statement emailed to HealthPayerIntelligence.

Individuals with rare or complex conditions may seek out second opinions from providers. These secondary opinions can have significant implications for patient outcomes.

The Clinic by Cleveland Clinic reported that nearly three out of every ten patients receive a changed diagnosis when they search for a second opinion. Approximately three-quarters of patients alter their treatment processes as a result of a second opinion.

Cleveland Clinic works with the digital health company Amwell in order to offer virtual care solutions.

Through its partnership with The Clinic, Anthem will offer large employer members the opportunity to access a second opinion online. The Cleveland Clinic has 3,500 providers available to offer second opinions on members’ health.

“When it comes to complex and potentially life-threatening illness, we want to help ensure that our members are receiving the care and information they need and having access to second opinions from the top experts in the world, regardless of their location, promotes this,” said Manish Oza, MD, vice president of product development and account management at Anthem.

Anthem cited The Clinic’s technological capabilities and specialized care as two key drivers behind this partnership. The Clinic serves 550 advanced subspecialties. It provides concierge-style service and enables video consultations as health or employee benefits or a consumer product.

The Clinic executives projected that virtual second opinions would grow in popularity and that demand for these solutions would increase with time. The payer anticipated stronger patient outcomes as a result of the program. The program may even reduce healthcare spending for members who have complex conditions and chronic diseases by improving quality of care.

Both the payer and The Clinic have already indicated that they may expand this opportunity in the future, extending the technological solution to more employers and into more programs.

“This is just the start of our work with Anthem,” said Frank McGillin, chief executive officer of The Clinic. “Our partnership is further proof of the value of virtual second opinions for patients and health plans alike.”

In the past, Anthem has also used artificial intelligence in order to improve member engagement. For example, the payer developed Anthem Skill in order to support medication adherence and enhance member engagement.

Innovation with virtual solutions has been a key feature of the battle against the coronavirus pandemic.

Experts anticipated that virtual care would experience a revolution after consumer uptake spiked in 2020. Consumers’ expectations of virtual care and telehealth solutions rose after the initial coronavirus surge.

The coronavirus pandemic demonstrated that telehealth and virtual care options may be effective for addressing mental and behavioral healthcare needs.

However, payers have pushed beyond these areas of care to use virtual care and telehealth in unique ways. As they adopt virtual solutions in a variety of ways, payers also have to integrate these solutions into their typical care strategies.

Some payers have constructed virtual care platforms to connect members to nursing and provider staff more quickly. For example, Blue Cross Blue Shield of Rhode Island introduced a virtual care management platform to improve care management strategies and allow for more direct connection between members and their care teams.

Other payers have launched virtual-first health plans that seek to engage members through digital contact first. Virtual-first health plans incorporate a virtual primary care benefit and encourage members to use telehealth as their first touchpoint for care. 

Like Anthem and The Clinic, many experts are optimistic that these virtual care solutions are here to stay and will become even more integrated in the next few years.