In the realm of virtual care delivery, we are seeing digital technology, patient-centered care and tools for the delivery of population health management converging, and enabling us to produce tangible value for stakeholders.
- Financial savings – When members with acute or complex cases have access to virtual diagnostic services, care management, and treatment support, there is a profoundly positive impact on costs, as the gaps in care are dramatically closed and care is used appropriately. In fact, virtual care delivery is already a consistent driver of financial savings. T-Mobile, America’s fastest growing wireless carrier, worked with Teladoc to help bring virtual care delivery to its employees and the results were significant. By redirecting care from emergency rooms and office/urgent care settings, Teladoc helped T-Mobile save $1,785,000 in 12 months. Combine that with $368,000 in productivity savings, and T-Mobile saved $2,153,000 in one year. Beyond the financial value, 96% of T-Mobile employees rated the experience with Teladoc as “excellent” or “good” and 99% said they would use Teladoc again.
CareFirst BlueCross BlueShield, the Mid-Atlantic’s largest health insurer, implemented a successful Patient-Centered Medical Home (PCMH) program. Although the organization could identify many members with high-cost claims, effectively engaging members receiving costly, misguided care proved to be more difficult. By seamlessly integrating the Best Doctors expert second opinion services into their existing care management pathways, CareFirst was able to identify its most complex cases, ensure accurate diagnoses and treatment, and realize considerable savings.
Prior to implementing the Best Doctors services, high-impact cases accounted for 76% of CareFirst’s hospital admissions. Through the implementation of Best Doctors service, CareFirst mitigated the financial risk of the highly difficult cases and realized an ROI of roughly 2:1. To date, Best Doctors has conducted more than 1,500 CareFirst case reviews, with all cases staying in-network, more than 83% of members following the expert’s recommendation and 95% of members who received a Complex Case Consult said they would refer a friend or family. “By making Best Doctors an integral, collaborative part of our care review process on high-cost, high complexity cases,” stated Chet Burrell, CEO CareFirst BlueCross BlueShield, “we are addressing and in many cases, minimizing adverse consequences while improving quality care for our members.”
- Increased member engagement and satisfaction – A growing number of business leaders rank employee engagement as a top priority — and challenge — for their organizations. Less than one-third of U.S. employees are actively engaged in their jobs, and even fewer regularly participate in the programs and benefits offered to improve their health and healthcare experience. This is another area where organizations will demand more from vendors in order topayers — expecting them to “make good” on their promise to deliver value by improving outcomes for members and by reducing “friction” for their employees to access services at lower costs to the employers unlock potential value. Virtual care delivery provides a unique opportunity to change the paradigm of health delivery from limited access and higher costs to increased access and lower costs by closing gaps in care. With just a 5% utilization of a telehealth benefit, redirection from facility-based care to telehealth care offers a 2:1 savings.
- Improved health outcomes – Telehealth is already evolving from providing care access for just episodic ailments to a full suite of medical conditions including chronic and critical complex health issues. With a central access point to a full continuum of care needs — and the top-rated physicians — patients members can trust that they will get high quality care and expertise, that is not standalone, but incorporated within the existing health system. This means that existing records are reviewed, and expert diagnoses and results are rapidly shared with a patient’s primary care physician and treating specialists. With co-morbidities found in 29% of virtual care cases, the need is pressing for this integrated care, and telehealth possesses the unique ability to fill the gaps. Expert second opinions, treatment decision support, and pathology reviews are just a few of the expanded virtual services that dramatically improve outcomes. In many instances, members who received a Best Doctors expert second opinion realize improved health outcomes, through the appropriate use of care — in some instances, 37% surgical avoidance—which translates into dramatic value for organizations.