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Virtual Health Supports Improved Patient-Physician Relationship

As hospitals and health systems continue to battle COVID-19, organizations have simultaneously begun to solidify and refine the virtual health investments made over the past several months. Organizations considering how virtual health may provide clinical and financial value are now also considering how virtual health may impact the patient journey.

For leading organizations, this means moving beyond the idea of virtual visits as separate from in-person visits and embracing the idea of the patient as the point of care.

The increase in virtual health utilization has begun to dispel physicians’ long-standing concerns around virtual visits. While historically clinicians have expressed that they did not feel virtual visits would impact the patient-physician relationship, new data is beginning to dispense with this notion. In a recent study of visits, patients were asked to comment on what their virtual visits had helped accomplish.

In the study, researchers found that a majority of patients responded positively on the interpersonal connection and relationship-building aspect of video visits. Approximately 30% of patient comments were classified as “building rapport,” with the next highest-frequency code defined as “shares information/provides guidance,” and the third most frequently cited being “user experience.” In comparison, “provided treatment,” which is often associated with receiving a prescription, was only listed 2% of the time. These results support that patients and physicians are able to establish and maintain a relationship utilizing only video visits and positive ratings do not seem to be focused solely on prescription receipt.

Although the reasons for patients’ disproportionately high satisfaction with video visits are unclear, some have surmised that physicians are often significantly focused on the EMR during in-person encounters. Conversely, with video visits, physicians can actually make eye contact and conduct the entire conversation face-to-face. These positive experiences have continued to solidify virtual health as an essential asset moving forward.

In particular, organizations have significant opportunities to utilize virtual health to further support Medicare patient populations who have disproportionately been at risk during the COVID-19 crisis. According to a recent survey, 91% of Medicare Advantage (MA) participants reported a favorable experience with virtual health, and 78% added that they planned to utilize virtual health again. These results align well with the expanded flexibility that CMS has provided to MA plans, allowing them to include robust virtual health capabilities in their overarching offerings.

Federal Action Would Improve Access to Care

It has become widely accepted and understood that patients like receiving care virtually and that virtual health can provide high-quality care. However, for virtual health to support care delivery across the country in perpetuity, several significant challenges need to be addressed. In particular, there are 2 areas that continue to remain a persistent hindrance to robust virtual health adoption.

First, inconsistent approaches to coverage of virtual health services is the most well-known and understood obstacle to significant virtual health adoption. While there have been some progressive payers in virtual health coverage, commercial payers have often been more limited in their coverage of virtual health than their public counterparts. In recent months, while several commercial insurers have publicly stated their support for virtual health—and as virtual health utilization has skyrocketed—many who initially announced they would waive fees for virtual health visits or reimburse them at equal rates as in-person visits, have quietly rescinded these progressive policies.

CMS has made numerous policy changes over the past few months, and health care executives and stakeholders continue to advocate to congressional and administrative leadership the importance of solidifying the changes. While congressional leaders from both parties have signaled support for extending many of these changes, in the past, there has been a reluctance to adopt broad telehealth policies, including those where payment would be on par with in-person rates, due, at least in part, to cost concerns. Yet, redacting patient access to telehealth would significantly undercut the progress made by providers before and during the COVID-19 public health emergency, lead to precipitous decreases in virtual health utilization, and overall, restrict access to care for many patient populations in need of care.

Second, inconsistent and limited access to robust broadband infrastructure continues to be a challenge. Recent congressional activity, though, aims to dramatically improve this situation. For example, the Healthcare Broadband Expansion During COVID-19 Act would provide $2 billion to support the Federal Communications Commission’s Rural Health Care (RHC) Program. The RHC Program provides support to rural communities; however, during the COVID-19 crisis, the RHC Program has already moved through the funding provided prior to the COVID-19 pandemic, leaving rural health communities facing severe connectivity issues.

Consistent access to high-speed, broadband infrastructure would support select communities in overcoming the digital divide. Underserved patient populations disproportionately live in rural geographies and in urban communities that are experiencing socioeconomic disparities that have led to inequities in health care outcomes. Ultimately, many patients and providers can’t access or afford reliable broadband or devices used in virtual health.

As you consider the opportunities related to virtual health utilization for various patient populations, consider the following recommendations for long-term success:

  • Ensure that your organization is seeking opportunities to provide robust training, credentialing and support to your physicians as they adopt virtual health services. It is necessary to establish a consistent experience across all sites of care, whether virtual or not, as well as across providers.
  • Collaborate with health care leaders to provide data and other supporting information to highlight how virtual health is improving care in your organization.
  • Seek opportunities to regularly monitor and adhere to federal and state laws and regulations to assure compliance.

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