Michigan partnership bets on virtual visits for uninsured

Accessibility and affordability are inextricably linked in America. If one does not have health insurance, one likely cannot afford healthcare -- a predicament that millions nationwide are in. As a result, the uninsured population is more likely to forgo or delay healthcare. Even amid the virtual care boom of recent years, which expanded care access for several medically underserved groups, the uninsured population remained less likely than their peers to use healthcare services.

In Michigan, a new partnership between Priority Health, a nonprofit healthcare payer, and Curai Health, a virtual care provider, aims to address these care gaps by offering free virtual visits to the uninsured through the end of the year.

"When we thought about really wanting to invest in our communities, what better way is there than to offer free access to healthcare services for those who need it the most and might be facing the most barriers to getting that care?" said Rick Abbott, senior vice president of employer solutions at Priority Health, in an interview.

If the partnership between Priority Health and Curai is successful in Michigan, it could offer a blueprint for other states looking to expand healthcare access to their uninsured populations.

Why expanding care access for the uninsured is essential

Though the uninsured rate dropped to a record low in 2022, there are still 25.6 million uninsured individuals in America. This population faces substantial barriers to healthcare access, including the prohibitive cost of healthcare. Even after they have accessed healthcare, the uninsured population must contend with unfair treatment and mounting medical debt.

Michigan has made significant strides in decreasing the rate of uninsured individuals in the state; however, in 2022, the state still had 470,700 uninsured individuals, from infants to age 65, representing 5.8% of the total population, federal data shows.

Priority Health is Michigan's second-largest health plan, covering 1.3 million members through various health plans for employers and individuals, including Medicare and Medicaid. However, Abbott noted that the significant number of uninsured in the state creates a ripple effect, adversely affecting healthcare affordability for all Michiganders, including Priority Health's members.

When we thought about really wanting to invest in our communities, what better way is there than to offer free access to healthcare services for those who need it the most and might be facing the most barriers to getting that care?

"The uninsured often drive costs -- they don't get [or] seek access to care that they need, so their medical conditions get exacerbated over time," he said. "And eventually that leads to urgent care visits and ER [emergency room] visits that are very costly and do actually make healthcare less affordable for those in this market and across the country."

By enabling free virtual visits through the new partnership, Priority Health aims to improve access and reduce healthcare costs statewide.

"We not only can improve the quality of care for those residing in this state, but we also can help really bend the healthcare trend and really try to address costs that, again, often show up at inappropriate places like the ER when they could be managed through something just like virtual care," Abbott said.

How virtual care can extend care access for the uninsured

Virtual care has proven effective in expanding convenient and seamless access to care. Priority Health and Curai Health plan to leverage these hallmarks of virtual care to enhance care access among Michigan's uninsured.

Curai Health is a chat-first virtual visit platform with artificial intelligence capabilities, explained Nicole Bell, the company's chief business officer, in an interview. Founded in 2017, the company provides primary and urgent care services nationwide.

Bell noted that the company's platform utilizes advanced automation tools and large language models (LLMs) to enhance interactions with patients and assist the company's employed clinicians. For example, AI-based chatbots collect patient information through intake questions and develop a proposed care plan. The information and proposed care plan are then passed along to a human clinician, who is responsible for diagnosing and providing patients with an official treatment plan.

"Our AI stops short of [diagnosing and providing a treatment plan], but the assistance that it gives empowers providers with information to give better and more complete healthcare faster," Bell said.

Curai's clinicians can also send remote prescriptions to pharmacies, order lab tests and provide referrals to brick-and-mortar providers.

The platform's AI capabilities offer unique advantages in enhancing patient care and controlling costs. According to Abbott, the platform allows treatment plans to be personalized for each patient. In the case of minor illnesses and injuries, patients can be steered to the appropriate level of care, reducing the risk of unnecessary healthcare utilization. And in the case of more severe medical needs, the chat-based service can provide advice on how to manage their condition while they wait for in-person care.

"Can we solve all of the problems that a particular individual might have? No, but at least we're giving them access to a physician to really get a consult and then to get a care plan that they can take and try to act upon themselves," Abbott said. "So, we're at least giving them an access point into the healthcare system."

This model in Michigan could be a model for consideration for other states, other payers and other public health institutions. It's a very affordable way to test if people who are given this kind of barrier-free access will use it and avoid worse outcomes. It's such an affordable way to give access.

The chat-based service is also designed to reduce patient barriers to video-based telehealth services.

"Some people feel they need to get ready to be on camera," Bell said. "You don't have to do that [with chat]. Also, to be on camera, you have to be in a stable place with good Wi-Fi, and the tech needs to work to message back and forth. [With a chat-based service,] you don't need to have very good Wi-Fi or strong broadband access. You could be on the move, you could be on a bus. And so, it's really a modality that doesn't interrupt the rest of your life and is barrier-free."

The initiative will continue through the end of the year. To measure its success, the organizations will examine the number of uninsured patients in Michigan who participate in virtual visits through the chat-based program and assess patient satisfaction.

Bell stated that patients are surveyed after every visit, Curai Health asks three questions: First, what is your one-to-five-star rating for the technology? Second, what is your one-to-five-star rating for your provider? Third, what would you have done if you hadn't used Curai?

"And what we find really interesting is answers to that [third] question," Bell said. "Some people would have gone to the emergency room, which if you're uninsured, creates a very hard economic burden. Some people tell us they would've done nothing."

Eliminating the need for unnecessary ER or urgent care visits will ultimately reduce healthcare costs, Abbott noted. This is another metric that the organizations will measure: Was the initiative able to lower the total cost of care for the uninsured population in Michigan?

Based on these results, the organizations will decide whether to extend the initiative into 2025.

Not only that, but the initiative has the potential to be replicated in other states if successful, Bell noted.

"This model in Michigan could be a model for consideration for other states, other payers and other public health institutions," she said. "It's a very affordable way to test if people who are given this kind of barrier-free access will use it and avoid worse outcomes. It's such an affordable way to give access. And so, we look at Michigan, and we look at Priority Health as maybe a beacon that others should take advantage of."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.