Blue Shield of California says its virtual-first program cut wait times, saved money

A program that charges no copayments for virtual visits and takes virtual-first approach has enrolled more than 150,000 members and yielded savings of $468 per member per year, Blue Shield of California announced this week.

The program, called Virtual Blue, was started three years ago. The California health plan contracts with Accolade to supply the program’s primary care physician services and with TeleMed2U for specialist services. Accolade was acquired by Transcarent, an AI and telehealth company, for $621 million in 2025.

“In this post-COVID world, getting access has probably been one of the hardest things for people, and this is comprehensive care they can get virtually,” Tim Lieb, senior vice president of growth at Blue Shield of California, said in an interview with Managed Healthcare Executive.

Lieb also mentioned the equity effects of virtual care, which he says enables people to get care without taking time off from work, and the cost savings. According to a news release issued by the Blue Shield of California, the overall cost of care of members in the Virtual Blue program was 7% to 10% less than comparable members not in the program. Those savings were reflected in lower premiums for payers, according to Lieb. A 10% decrease in emergency room visits was instrumental in producing the savings, according to the Blues plan.

The news release says that among a subset of members with multiple chronic conditions or those who require more frequent care, the savings associated with the Virtual Blue averaged $17,280 a year. Lieb didn’t have immediate access to the number of members in that category.

Virtual care, or telehealth, took off during the COVID-19 pandemic and the related public health emergency. A number of insurers, including United Healthcare, Harvard Pilgrim and Priority Health, made announcements about launching virtual-first health programs similar to Blue Shield of California’s.

Related: Are Virtual-First Health Plans Headed to the Front of the Line?

Last year, researchers at CVS Health’s Clinical Evidence Development unit reported results of a retrospective study comparing virtual-first care to in-person care in BMC Health Services Research. They reported that among Medicare Advantage members, the cost of virtual-first episodes was 10% to 24% less than in-person care for six of 11 conditions, including otolaryngology disease, rhinitis, gastroenterology disease, minor bacterial skin infections, sinusitis and bronchitis. Among members in fully insured commercial plans, virtual-first episodes were 9% to 33% less costly than in-person for 12 of 16 conditions, including urinary tract infections, viral skin infections, gastroenterology disease, rhinitis, otolaryngology disease, sinusitis, urological disease, contact dermatitis, viral pneumonia, bronchitis, fungal skin infections, and minor bacterial skin infections.

The news release from Blue Shield of California called out shorter wait times as one of the highlights of Virtual Blue. Members in the program waited one day to get a primary care or mental health visit compared with the statewide average of 10 days, a figure based on data reported by the California Department of Managed Health Care. For specialty care, the wait time for Virtual Blue was three days compared with the statewide average of 15 for an in-person visit.

Lieb said that although Virtual Blue was not strictly speaking a pilot project, the rollout was gradual partly so the company could learn and adapt as it was implemented. Approximately 80 employer groups are offering it as an option. The number of people who have signed up for it is just 2.5% of the California plan’s 6 million members.

Lieb said the health plan will continue to offer Virtual Blue, but it is also looking to incorporate virtual care into its other preferred provider organization and health maintenance organization plans. The company’s news release mentions that Blue Shield has added virtual primary care options to its Trio HMO plan.

Lieb said that Virtual Blue was designed with zero copayments because ease of access was a major goal, but that employers may tweak virtual care plans in the future so there is a small copayment.

Making sure that members understand that virtual care does not preclude in-person care when needed is one goal that Lieb has. “What I want to make sure of is that people don’t think, ‘Well, all of my care is virtual.’ It [Virtual Blue] was completely surrounded by brick and mortar — the ability to go and seek additional care if it can’t be done virtually.”