Primary care physicians are the heart of healthcare delivery in the United States. In addition to providing many crucial health services, they are the traffic cop to all the other forms of healthcare throughout a health system.

Virtual primary care, experts say, can address challenges in traditional care by filling existing care gaps and offering various benefits to healthcare organizations, providers and patients.

A big chunk of telemedicine technology and services company Teladoc Health's business is in primary care.

We interviewed Kelly Bliss, president of U.S. group health at Teladoc Health, to discuss how virtual primary care can provide high-touch care coordination for preventive care, chronic condition management and mental health services; bring cost savings from lower out-of-pocket expenses and premiums, as well as avoiding unnecessary or repetitive care in brick-and-mortar settings; and improve access to care and the patient experience.

Q. You contend virtual primary care can amplify value in several ways. First you suggest it can provide high-touch care coordination for preventive care, chronic condition management and mental health services. Please explain how, and the value virtual primary care adds here.

A. Virtual primary care serves as the access point to bring individuals into the healthcare system and by bringing the healthcare system to the individual, where they want to receive care. And most of the time, that is at home.

It is perfectly positioned to deliver integrated care as it can act as a hub for other services (mental health, chronic condition management, specialty care) and be paired with a hybrid, in-person experience when medically appropriate.

It knocks down the historical challenges to primary care access and better connects people with detection, prevention and condition management, empowering them to live their healthiest lives.

For example, within our own program, 38% of the diabetes diagnoses were newly diagnosed, and 25% of individuals diagnosed with hypertension were similarly newly diagnosed by their Teladoc primary care provider. These are diagnoses that would have otherwise gone unnoticed, leading to uncontrolled outcomes.

And virtual-first doesn't mean virtual only. It's vital virtual primary care work in conjunction with the broader healthcare ecosystem, digitally and physically connecting patients to in-network specialists when appropriate.

For example, many individuals are behind preventive screenings for things like colorectal, breast or cervical cancer, and a lot of this knowledge is gathered or learned within a virtual primary care visit. Strong virtual care programs will connect the dots for members and help guide them to the right follow-up care.

Q. You also contend virtual primary care brings cost savings from lower out-of-pocket expenses and premiums, as well as avoiding unnecessary or repetitive care in brick-and-mortar settings. Please elaborate on this suggestion, and on the value created.

A. Primary care has long been known and recognized as a model to curb rising costs. Individuals without a primary care physician are often behind on health screenings, struggle to manage their chronic conditions, and are more likely to use high-cost settings, like urgent care or the ER, often for care that could have been treated in the primary care setting.

The convenience of virtual primary care – combined with its ability to support better preventive care – reduces unnecessary ER visits and guides members to the most cost-effective healthcare service.

Virtual primary care embedded in a virtual-first health plan can have an outsized impact on affordability, both at the employer/health plan sponsor level and the member level. The digital accessibility of virtual-first health plans combined with low or no copays motivate individuals to seek preventive care early and often, reducing risk of disease state progression and unnecessary hospitalizations.

These plans are growing in popularity as consumers increasingly demand and expect a virtual component to their healthcare.

Q. You further say virtual primary care can improve access to care and improve the patient experience. How, exactly?

A. There are numerous challenges to in-person primary care today. I would say one of the larger barriers is the lack of access to a PCP in general. Many individuals across the country live in designated primary care deserts, leaving them with little or no access to the care they need.

According to recent studies, an estimated 100 million people, or one-third of Americans, don't have a primary care provider.

Additionally, wait times to see a PCP can be long (the wait for an in-person visit can take up to a month), and actual visits with the PCP can be quite short. Even finding time for an appointment can be difficult, given unique work schedules, family commitments and more.

Virtual primary care can eliminate these geographical barriers to care. It removes a lot of inconsistencies and disparities in care, and with it, individuals can get the same quality of care regardless of the community they live in.

Virtual primary care also allows for more flexibility in the timing of scheduling appointments and convenience in where and how appointments are facilitated. Individuals can connect with their PCP and care team by phone, video or in-app messaging with an appointment or on-demand.

This is especially convenient for patients in rural or remote locations and low-income areas who may face transportation barriers.

Virtual primary care visits also last longer than in-person visits, with some initial visits lasting more than 45 minutes. Individuals can build a better rapport and trust with their PCP this way, which can improve care plan adherence and more. We are seeing these relationships translate to member satisfaction levels of over 95%.

While virtual primary care is an important first step in improving health outcomes, sometimes in-person services are still needed. This is another area where virtual primary care shines: a strong virtual care offering ensures individuals can connect with other, high-quality care within their network as needed, whether that be for lab tests, chronic condition management, cancer screenings, fertility benefits, mental healthcare and more.

Q. It has been reported the national average wait time to see a new primary care physician is nearly a month. What is the value proposition virtual primary care can bring here?

A. Long and inconvenient wait times are a major issue that deters people from engaging in primary care. As mentioned, the national average wait time to see a PCP is nearly a month. This is largely due to a shortage of primary care physicians across the country, and some communities are disproportionately impacted by this.

But with virtual primary care we can remove those geographical barriers and provide individuals with access to clinicians beyond the ones in their Zip code. It can provide access to primary care within five days in all Zip codes in the country, providing individuals that previously lacked access a fair chance to begin their preventative healthcare journey.

That is a significant difference, and that extra time can mean the world for early identification and timely treatment, which are essential for patients with diabetes, hypertension and other complex conditions. In fact, we are seeing the oncology referrals made by our clinicians and the subsequent early detection of cancer literally save lives.

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Email him: bsiwicki@himss.org
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