Health Insurers Offering a "Virtual-First" Option

MHE Publication, MHE January 2022, Volume 32, Issue 1

For many people, telehealth is an inviting option. But some insurers are offering health plans that make it the main way by which people receive primary care.

For many people, telehealth is an inviting option. But some insurers are offering health plans that make it the main way by which people receive primary care.

In October 2020, Priority Health, one of the largest health insurers in Michigan, announced it was offering a “virtual-first” option to some members. Starting last year, Priority Health members who signed up for one of three MyPriority Telehealth primary care provider (PCP) plans had all primary care visits conducted virtually through its provider partner, Doctor on Demand, a group of physicians and other providers who deliver all care via telehealth.

Any member needing to see a specialist in person would need a referral from their PCP, Priority Health said. The new plans were designed for those who are comfortable with online interactions with providers, says Carrie Kincaid, Priority Health’s vice president of individual markets.

Related: Telehealth Grows, but Medicare Has Woes

Following Priority Health’s lead, three other insurers announced this year that they will offer virtual-first plans in 2022. CVS-Aetna announced in August 2021 that it would partner with Teladoc Health to offer a virtual plan to employers nationwide. UnitedHealthcare and Centene Corporation have also jumped on the virtual-first bandwagon.

Centene said it partnered with Teladoc Health to provide virtual care in Michigan, Mississippi, South Carolina and Texas. UnitedHealthcare offered its NavigateNOW virtual-first plans in Dallas, Houston, Minneapolis, Indianapolis, Pittsburgh and several other cities.

Members who choose the NavigateNOW get around-the-clock access to care and same-day appointments and have no copayment for virtual and in-person primary care. There is also no copayment for behavioral health visits and virtual urgent care, the insurer said in a news release. Employers’ premiums for NavigateNOW plans are 15% lower than comparable health plans, UnitedHealthcare said in its press release.

In November, SCAN Health Plan, which offers Medicare Advantage plans in California, launched Welcome Health, an independent primary care medical group that will treat MA members through a combination of virtual and in-home visits.

In an interview with Managed Healthcare Executive®, Kincaid said that Priority Health introduced three virtual-first plans on the individual market in Michigan. One is a bronze plan, the other two, silver. About 5,000 people signed up for plans. Kincaid said that 60% of members who responded to a patient satisfaction survey rated their satisfaction at 4.8 out of 5 stars.

“When introducing these plans, we were very focused on wanting to improve the quality of care that patients receive through the accessibility of this product,” she said. Priority Health has noted that some of the patients enrolled in virtual-first care are more engaged in their care than they were previously, she added.

“Among members with diabetes we’ve noticed that they are more engaged in their care and, as a result, they’ve been able to bring their A1C scores down significantly,” Kincaid said. “Other members have brought their weight down.”