Payers Can Use Telehealth to Increase Convenience for Members

Consumers prioritize convenience

Convenient access to care has surged forward to become a priority for patients. Ninety-two percent of consumers indicated that convenience was somewhat or very important to them due to coronavirus.

“The COVID-19 pandemic underscored the importance of providing accessible care, not just in times of need, but always,” the study stated.

CVS Health emphasized how its HealthHUBs seek to meet that need. The organization anticipates having 1,500 HealthHUBS open by 2021, providing preventive care, primary care services, and chronic disease management support. CVS Health announced the launch of first of these sites in 2019 along with CVS Health’s new pharmacy benefit management service.

Beyond physical locations, however, convenience attracted consumers and providers alike to digital health and telehealth solutions.

Nearly half of the consumer respondents (48 percent) said that they were more likely to connect with their provider if the conversation could be held via digital messaging, which was an increase of seven percentage points from a similar survey conducted the previous year.

Almost one in three respondents (32 percent) were more likely to communicate with their provider through telehealth—an increase of 13 percent from 2019. And thirty percent of participants were willing to connect through a virtual office visit on a video conferencing platform (29 percent), as opposed to 20 percent in 2019.

“Consumers are demanding convenience and ease in how they access health services. Technological solutions have the power to simplify health care and significantly expand the ways we deliver it,” said Merlo.

The payer industry experienced a spike in telehealth claims as the coronavirus pandemic settled in and providers deferred all in-person, non-urgent care.

A survey from early on in the pandemic (March 19 through March 20) showed that public opinion regarding telehealth suggested that consumers had mixed feelings. Around 40 percent replied that they were considering using telehealth but had yet to do so. The respondents mainly voiced concerns about quality of care and the platform’s accuracy, as well as security.

Once consumers moved past the initial hurdles and used telehealth, though, there was a high return rate—almost six in ten said that they had already used telehealth more than once and nearly four in ten (37 percent) affirmed that they would use it again.

Since that survey, many more consumers have been exposed to telehealth as the public health emergency lengthened. Some payers saw their telehealth claims jump as high as fifty times their usual amount.

Consumers need mental and behavioral healthcare services

Consumers are also acutely aware of the need for mental and behavioral healthcare services. Over a quarter said that someone in their household struggled with a mental health condition. Consumer acceptance of digital solutions continues into this sphere, with four in ten consumers being very likely to conduct a mental or behavioral healthcare visit virtually.

The researchers found that 62 percent of consumers went to their primary care physician at the time that this survey took place, which was an increase from 2019 levels by three percentage points.

During the coronavirus pandemic, CVS Health created the Aetna employee assistance program, Resources for Living, available to any member who had experienced coronavirus-related impacts. The resource provided mental health support, community resources, and employer consultations.

Consumers need greater price transparency

Cost continues to be a major barrier to accessing healthcare. Over one in three participants confirmed this and almost half said that costs prevented them from seeing a provider. Over seven in ten expressed great concern regarding chronic disease management due to the cost.

Around 70 percent of consumers were worried about out-of-network care costs, deductibles, and monthly premiums.

As a result, CVS Health emphasized the need for better price transparency.

Price transparency is another area in which payers can leverage digital solutions. CVS Health noted that its pharmacy benefits manager, CVS Caremark, implements real-time benefits technology to give providers five prescription options that are lower cost and still applicable for their patients.

Providers need more support

The study also revealed that payers can better support their providers.

Three-quarters of providers voiced that they were experiencing burnout to some degree— very frequently, frequently, or sometimes. Provider administrative burden was one of the primary drivers of this exhaustion. Specifically, maintaining EHRs and documenting services poses a significant burden along with other administrative requirements.

Payers worked to diminish provider burden during the coronavirus crisis primarily by waiving certain requirements. Specifically, many payers agreed to waive documentation and authorizations around hospital transfers and prior authorizations. In addition to these waivers, payers also employed telehealth solutions to decrease the demand on providers’ time.

Payers will need to balance these provider needs with members’ need for greater convenience in care.