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What Does Access Really Mean?

Working closely with our customers, I hear over and over that patient access is a key strategy and reason for launching virtual care. Taking a cue from our health system customers, we talk a lot about virtual care’s ability to expand and facilitate access to care. But what does that really mean? Who benefits from the expanded access that virtual care provides?

Meet Kate

One of the things I find really refreshing about working at Zipnosis is that we don’t stop at thinking about what our health system customers need. What I mean here is we’re also thinking about tMiddle Aged Telemedicine Patientheir patients. Who is using their virtual care platform? Why are they using it? What can we do to improve the experience for them?

We actually have well-realized personas covering several known users. The flagship persona is someone we call “Kate.” Kate is in her mid-30s, married with two kids who she chauffeurs  around in a late-model SUV. Kate works full-time and has insurance through her employer. She’s also the persona who drives our standard product demo – if you’ve ever seen the Zipnosis platform in action, it’s probably through the lens of Kate.

Recently, I began to think about Kate because access for her means something different than it does for a lot of the population. It’s really about convenience more than need. Kate could take time away from work, she could drive to see her primary care doctor for care, it’s just inconvenient to do so. But what it we took away Kate’s SUV, her employer-sponsored insurance, even her full-time job?

Meet Katie

Katie looks a lot like Kate on the outside. She’s also in her mid-30s with two kids, but instead of Kate’s SUV, Katie relies on public transportation. Instead of Kate’s employer-sponsored insurance, Katie has a high-deductible health plan that means she pays for most healthcare costs out-of-pocket. Instead of Kate’s full-time job, Katie works two part-time jobs and doesn’t have paid time off. What does healthcare access mean to Katie?

To answer that question, I gave myself an exercise: Put myself in Katie’s shoes and understand the decisions she needs to make when looking at where—and whether—to seek care for a common condition like a UTI. Here’s what I learned:

In-Person Care Options

I looked at 4 in-person care delivery options: A primary care clinic, an urgent care center, a retail clinic, and the emergency room.

Work Schedules

Working two part-time jobs without PTO, Katie needs to find time to go to the doctor. That may mean determining if she can afford to take time off of work, coordinating shift coverage with co-workers, or finding an option that’s open when she’s free. That means the hours of operation and when an appointment would be available are major factors in decision making.

Primary care: 8 am – 6 pm; appointment availability “tomorrow”

Urgent care: 7 am – 7 pm most weekdays

Retail clinic (average): Weekdays, 9 am – 7:30 pm; weekends, 9 am – 4 pm*

Emergency room: 24 hours daily

*Lunch hours: Practitioners take a daily, required lunch break each day. Please note that lunch time are approximate and may vary.

Transportation

Part of managing schedules is figuring out the impact of public transportation. Katie needs to factor in schedules and routes. Then, she needs to determine how much time she’ll need to spend in transit. Using my house as a starting point, I determined that transportation would take anywhere between 15 and 45 minutes each way, most of which required walking about ½ mile in addition to the bus.

Child care

If Katie needs to seek care outside of her typical working hours or when the kids are not in school, she needs to consider what to do with her children. Does she haul them along to the doctor’s office? Does she get a last-minute babysitter – and is that practical from a financial standpoint?

Cost

Finally, with her high-deductible health plan transitioning the full cost of care to Katie, how much will she have to pay out-of-pocket for each of her options? The data shows costs varying widely for services, but the following are pulled from a Blue Cross Blue Shield (MA) fact sheet on typical costs for common services and Consumer Reports:

  • Primary care: $130 – $180
  • Urgent Care: $120
  • Retail Clinic: $55 – $75
  • Emergency Room: $400 – $700

Access with Virtual Care

Imagine the impact a virtual care offering could have on Katie. Access to a virtual care service effectively eliminates the need to balance her competing priorities.

Work Schedules – With virtual visits available via any internet-connected device, Katie doesn’t have to worry about missing work.

Transportation – Katie can access virtual care anywhere, so transportation ceases to be a concern.

Child care – Katie can complete a virtual visit while her kids do their homework at the kitchen table, or while they’re playing at the park.

Cost – Unlike the more costly in-person options, most of our health system customers charge between $20 and $40 for a virtual visit, making it far and away the most affordable option.

With virtual care, Katie can quickly, easily, and affordably receive care for her UTI – without the stress and worry. Virtual care may well be working to bring convenience to the Kates of the world – and that’s no small thing – but our greater impact is in the benefit we bring to the Katies.

Value-Based Care: It’s Here and Virtual Care is Part of the Equation

We’ve all seen the news. Value-based care is coming, it’s inevitable, it’s here. But many health systems have yet to see major impacts from value-based reimbursement models such as accountable care organizations (ACOs), bundled payments, or patient-centered medical homes. Consequently, it’s easy to think that the hype around value-based care is just that: hype. We need to think again.

It’s not Hype

Value-based care really is coming, and soon health systems won’t be able to escape it. In early 2015, the Healthcare Transformation Task Force announced that 20 major health systems and insurers committed to moving 75% of contracts into value-based arrangements by 2020. The U.S. Department of Health and Human Services (HHS) expects that by the end of 2018 half of Medicare payments will go to alternative payment models, such as ACOs and healthcare organizations that accept bundled payments. And, a 2014 study by Avility revealed that more than 60% of providers expected value-based payment models to become dominant going forward.

What is Value-Based Care?

Traditionally, reimbursement has been volume-based. Under this model, providers are paid based on the number and type of visit. At its core, value-based healthcare encompasses a series of alternative payment models designed to support the triple aim of better patient access, lower healthcare costs and improved clinical quality. These models include accountable care organizations (ACO), patient-centered medical homes (PCMH), pay-for-performance and bundled payments. Under each of these payment models, health systems and providers are rewarded when they deliver quality care using fewer resources.

So, how can health systems who still operate in a volume rather than value-based reimbursement environment get ready for the shift? Look to virtual care.

The Impact of Virtual Care in a Value-Based Environment

Health systems looking toward the transition from volume to value-based care can benefit from launching a patient-provider virtual care solution. Virtual care can help health systems reduce costs by transitioning patients to a lower-cost access point, minimizing office visits, urgent care encounters and even trips to the emergency room. Health systems can also see the benefit of enhanced patient health outcomes, including stronger patient engagement and population health management.

Dr. Deborah Greer of John Muir Health discusses the online adaptive interview from the perspective of value-based care. 

Lowering Cost of Care

The online access point in a virtual care service offers health systems and patients a lower-cost diagnosis and treatment option. Using a “store-and-forward” solution like the Zipnosis online adaptive interview enables providers to diagnose and treat common acute conditions quickly and efficiently. Provider time per visit on the Zipnosis platform is typically around 2 minutes to diagnose and treat, compared with 15-20 minutes for an office visit.

Improving Patient Outcomes

Patient engagement isn’t just an industry buzzword. According to HealthAffaris.org, people who are actively involved in their health and healthcare tend to have better outcomes. Offering a convenient, online access point can help increase engagement by making healthcare fit into patients’ lives. Additionally, patients may seek treatment through a virtual access point when they might otherwise decide against seeking care. That could be the difference between a routine UTI and a serious kidney infection.

Health systems and patients can also use virtual care as a population health tool. Online health assessments, for example, can help identify patients who are at risk for chronic conditions before those conditions become problematic. And, using an online access point for follow-up visits can help keep patients engaged in their care by making it quick and easy to provide their physicians with health information in between office visits.

Act Now to be Prepared for the Future

In the 2016 HIMSS Cost Accounting Survey only 3% of respondents indicated their health systems were highly prepared to to adopt value-based care reimbursement and leave behind volume-based, fee-for-service payment models. A full transition to value-based care may seem distant, but leading health systems are taking steps to prepare for the inevitable transition to value-based reimbursement.

Health systems who launch virtual care as a means for providing cost-effective care in a value-based environment will have the time to:

    • Work through change management and build clinician buy-in across their organization
    • Develop and implement a strategy that ties together online care delivery across departments and specialties
    • Monitor and enhance their virtual care service to ensure it meets the needs of both patients and the health system
    • Fully integrate virtual care with internal IT systems to promote a seamless patient and provider experience

Want more information on virtual care? Check out our guide to best practices!

Solving the Patient Engagement Puzzle with Virtual Care

Patient engagement is becoming increasingly important, and virtual care offers health systems a solution to meet patient needs while fitting healthcare into their lives. Kevin Smith, Zipnosis’ Chief Clinical Officer and innovative healthcare pioneer, discusses how virtual care can help health systems better engage with patients to boos patient retention and minimize patient leakage.

Resources

Calculator: Patient Leakage

Offering Virtual Care to the Marketplace

  • Offering virtual care can help you capture more patient visits and prevent visits from leaking out of your health system, directly impacting your bottom line. Answer a few easy questions and find out how much your health system could be leaving on the table.
  • Logic

    Back End Calculations

Calculator: Cost Shift Revenue

Offering Virtual Care to Covered Populations

Webinar: How to Get Virtual Care Right the First Time with Bryan Health

Bryan Health Webinar: How to Get Virtual Care Right the First Time

Learn how a leading health system successfully launched and took their virtual care service to market. Dr. Brian Bossard and Andy Whitney from Bryan Telemedicine, the virtual care arm of Bryan Health, share their first-hand experience selecting and launching their virtual care service line. They provide insight into the differences between virtual care solutions, best practices for bringing a virtual care service to market, and how virtual care can improve patient acquisition.

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White Paper: Patient Acquisition Provides Sustainable Financial Model for Virtual Care

In today’s landscape, non-profit and public healthcare organizations, which include the majority of community hospitals, are facing a negative economic outlook. As such, demonstrating the financial impact for new service lines is increasingly critical.

MultiCare offers virtual visits using two distinct platforms under the name MultiCare Virtual Care: an asynchronous online patient interview powered by Zipnosis, and a direct-to-video service.

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Webinar: Launching and Scaling Virtual Care with Ascension Wisconsin

Ascension Wisconsin Webinar: Launching and Scaling Virtual Care

William Brazeau, Virtual Care System Director at Ascension Wisconsin, shares Ascension Wisconsin’s first-hand experience launching and strategically growing their virtual care service line. William provides insight into why and how Ascension Wisconsin launched virtual care, optimization of their virtual care service offering, and Ascension Wisconsin’s virtual care service results.

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