Virtual Health Can Reduce Health Outcome Inequities, but Challenges Remain
As the virtual health landscape continues to evolve, its impact on reducing the inequities in health outcomes that occur across demographics is coming into view. According to one study that investigated claims data across various demographics, Hispanic respondents used virtual health more frequently than any other group. During one period analyzed, 21% of Hispanic respondents used a virtual health service compared to 16% of non–Hispanic Black respondents and 13% of non–Hispanic White respondents.
This disproportionate utilization among Hispanic individuals and non-Hispanic Black individuals positions virtual health services to impact the overall health of a community, as both groups suffer dramatically higher rates of chronic illness than the national average.
Patient populations living in rural geographies may also be able to benefit from increased access to virtual health care services, as those who live in rural communities often experience significant health disparities, including higher incidence of disease and/or disability, increased mortality rates, lower life expectancies, and higher rates of pain and suffering. Rural risk factors for health disparities include geographic isolation, lower socioeconomic status, higher rates of health-risk behaviors, limited access to health care specialists and subspecialists, and limited job opportunities. Rural residents are less likely to have employer-provided health insurance coverage and, if they’re poor, are often not covered by Medicaid, which intensify health inequities.
Virtual health has been shown to help overcome many of the health care limitations often seen in rural geographies, though it also has its own challenges. While virtual health alleviates the need for transportation, childcare and time for in-person visits, it relies on the patient having access to technology, digital literacy and broadband infrastructure. These technological limitations pose a risk of further exacerbating health outcome inequities if they are not addressed in virtual health program structures.
Additionally, inconsistencies in reimbursement, regulations and the overall cost of virtual health for patients may serve as a hindrance to virtual health delivering benefits to both patients and hospitals and health systems across the country. Recently, 2 of the largest health insurers, Anthem and UnitedHealthcare, announced that they are no longer waiving copayments and deductions for some patients starting on October 1. While the impact of this will vary dramatically depending on the type of visit and the details of the insurance policy, patients could end up paying anywhere from $55 to $92—the average cost range for a virtual visit within a plan’s network, according to an analysis of insurance claims.
This poses a significant challenge for patients across the country who are utilizing virtual health to receive care for chronic illnesses, many of who do not feel comfortable or safe receiving in-person care due to the current COVID-19 crisis. In addition to the existing challenges that patients are facing, many aren’t aware of virtual health or don’t understand when to access it or how to utilize its capabilities appropriately; furthermore, shifting reimbursement for virtual visits is continuing to create confusion. Patients and physicians both are experiencing uncertainty on what types of virtual visits will remain covered, the rate at which they will be reimbursed, and which insurers will cover them and for how long.
While some of this uncertainty is outside the control of hospitals and health systems, there are actions that senior leadership can take to ensure their organization is communicating the availability of its virtual health assets, the value that they deliver to patients in improving care and the scope of care that can be treated through virtual capabilities.
As you invest in your digital health program, consider the following recommendations for long-term success.
- Seek opportunities to develop programmatic solutions that are structured with the patient population you are focused on. This may require a significant analysis, including a thorough investigation of the geography, to understand the technical, financial and infrastructure limitations patients face in effectively using your virtual health offering. This may also require incorporating cultural nuances or preferences into your offering to ensure patients are comfortable receiving care in this way.
- Collaborate with internal stakeholders to ensure that your organization is incorporating changes in reimbursement and regulation guidelines into program workflows as they continue to evolve.
- Explore opportunities to establish innovative partnerships with commercial payers centered on shared savings arrangements or other mutually beneficial financial models.