What’s a Virtual First Health Plan?

As virtual-first health plans continue to evolve, healthcare providers must adapt to changing care delivery models and embrace the opportunities and challenges of providing care in a virtual setting.

Modern-day advancement has pushed the limitations of connectivity in various industries, including the healthcare sector. And one of the new, convenient healthcare models brought forth from this is the virtual first health plan.

This term refers to healthcare consultations via digital connectivity devices like cell phones, computers, laptops, etc. It is an effective healthcare area that allows easy connectivity between patients and healthcare professionals.

What's a Virtual First Health Plan

The concept of a “virtual first health plan” can be broken down into two parts.

While health plan is self-explanatory, virtual first originated from the technology sector. It refers to an organizational model that prioritizes virtual connectivity.

Hence, since it’s based on new tech developments, the virtual first health plan providers rely on communication technology pieces such as videoconferencing, which are used for patient-physician connectivity.

On March 2020, when the pandemic hit, the demand for high-quality healthcare plans was boosted.

Thus healthcare professionals had to find a solution that could help patients and allow them to consult physicians within the safety of their walls.

The rise of telehealth, allowed more people to connect with their doctors in time of a healthcare emergency.

Importance & Relevance of Virtual Care in Healthcare

Virtual first healthcare has proved to be an excellent medium of patient-doctor connectivity.

Telehealth has revolutionized the healthcare industry by introducing convenience and comfort to patients. This model has made healthcare accessible to the most remote areas.

In today’s time when the lifestyle is fast-paced and extremely chaotic, virtual first healthcare plays a vital role in helping people prioritize their well-being. More and more providers are introducing new and improved telehealth programs.

That’s due to the fact that the global telehealth market is projected to grow from USD 90.74 billion in 2021 to USD 636.38 billion in 2028 at a CAGR of 32.1% in the forecast period from 2021-2028.

Types of Virtual Care Services

Virtual care services are classified into different categories:

Hospital-at-home (HAH)

This virtual healthcare solution is designed to deliver hospital-level medical service at the patient’s home.

The hospital-at-home model is highly convenient for patients that are suffering from acute diseases and require immediate and personal medical expert attention. The doctors and patients can connect to each other through phone calls or video conferences.

Remote Patient Monitoring (RPM)

RPM refers to virtual monitoring of the patients using different pieces of technology that allow the doctors to scale patients’ progress using remote devices.

RTM plays an extremely vital role in monitoring the effectiveness of medication or healthcare therapy. This helps the medical experts decide the next step with regard to the patient’s treatment.

Chronic Care Management (CCM)

Chronic Care Management is designed for people with chronic diseases.

These patients need regular health care check-ups which can be a bit of a hassle in terms of in-person consultation. Hence, CCM eliminates the extra leg work of visiting the hospital every time when a doctor’s check-up is required.

How a Virtual First Health Plan differs from Traditional Healthcare Plans?

The virtual first health plan is an outcome of technology.

Hence, some might argue that the virtual healthcare plan is more efficient and convenient when compared to a traditional healthcare plan. However, there are some aspects where virtual healthcare does not prove to be the best.

Feature	Virtual First Health Plan	Traditional Healthcare Plan
Access to care	Virtual visits are available 24/7, and members can often see a provider the same day they request an appointment.	In-person visits are typically only available during business hours, and there may be a wait for an appointment.
Cost	Virtual visits are typically less expensive than in-person visits.	In-person visits are typically more expensive than virtual visits.
Quality of care	There is no evidence that the quality of care provided by virtual first health plans is any different than the quality of care provided by traditional healthcare plans.	There is no evidence that the quality of care provided by traditional healthcare plans is any different than the quality of care provided by virtual first health plans.
Convenience	Virtual first health plans are more convenient for members who live in rural areas or who have difficulty getting to a doctor's office.	Traditional healthcare plans may be more convenient for members who prefer in-person visits or who need to see a specialist.
Flexibility	Virtual first health plans offer more flexibility for members who need to see a doctor outside of business hours or who need to see a doctor for a non-emergency issue.	Traditional healthcare plans may be more flexible for members who need to see a specialist or who need to see a doctor for a chronic condition.

Virtual Care as the Primary Mode of Healthcare Delivery

Virtual care has become an integral part of the healthcare industry. And virtual care plans are slowly becoming a primary mode of healthcare delivery.

Since these plans are cost-effective and highly convenient, they are becoming a first choice for people seeking health care services. No matter the ailment, the first step of medication treatment usually is to consult with a healthcare expert.

This can be easily done through telehealth care solutions.

If the treatment does not involve in-person interaction, both sides can proceed forward with a virtual healthcare plan. A virtual interaction will also give a clear idea to the healthcare professional whether the patient needs an in-person consultation.

Cost-Effectiveness

The cost-effectiveness of a virtual healthcare plan is a significant advantage that sets it apart from traditional healthcare plans. Hence, virtual healthcare can offer several cost-saving benefits for both patients and healthcare systems.

Firstly, virtual consultations and remote healthcare services eliminate the need for patients to travel to healthcare facilities, saving on transportation costs and reducing the associated time and inconvenience.

Patients can access healthcare services from the comfort of their homes or any location with an internet connection, minimizing the expenses associated with in-person visits.

Additionally, virtual healthcare plans can potentially reduce overall healthcare costs.

By leveraging digital communication tools, telemedicine, and remote monitoring, virtual healthcare plans can help prevent unnecessary hospital visits and emergency room admissions, which tend to be costly.

Remote monitoring of patients with chronic conditions can lead to early detection of potential health issues, enabling timely intervention and preventing expensive complications.

Advantages of a Virtual First Health Plan

Eliminating the Doctor-to-Patient Gaps

Healthcare experts are seamlessly accessible to people residing in urban areas. However, this might not be the case for rural areas residents. The virtual first healthcare plans allow people to connect with clinicians regardless of their place of residence.

Accessibility to Specialists

Finding medical experts who specialize in specific healthcare areas is not always an easy task; on the contrary, it can be quite a challenge depending on where the patient is located. This makes medical consultancy a hassle for patients. However, with virtual-first healthcare plans, patients can seamlessly access the right medical specialists.

Cost-Efficient Solution

According to Harvard Health, virtual healthcare costs half as much as an in-person doctor visit. This helps countless people access high-quality healthcare services without burning a hole in their pockets.

Enhances Chronic Disease Management

People suffering from chronic diseases require regular medical care and attention. With virtual-first healthcare, chronic disease patients can connect to medical experts without compromising their daily schedules.

Flexible Appointments

Telehealth offers flexibility to doctors and patients. Both sides can choose the time of availability accordingly rather than sticking to a strict time schedule provided by the clinics.

Challenges & Considerations

While virtual-first healthcare offers numerous benefits, there are also several challenges and considerations that need to be taken into account. Here are some of the key challenges and considerations:

Access & Technology

One of the primary challenges is ensuring widespread access to technology and a stable internet connection. Not everyone will have reliable internet access or the necessary devices to participate in virtual consultations.

This can create disparities in healthcare access, particularly among underserved populations or rural areas.

Digital Literacy

Adequate digital literacy is essential for patients to navigate virtual healthcare effectively. Some individuals, particularly older adults or those with limited technology experience, may face challenges in using virtual platforms or understanding how to access and manage their healthcare online.

Healthcare providers need to provide appropriate support and guidance to address these barriers.

Privacy & Security

Maintaining patient privacy and data security is crucial in virtual healthcare.

Healthcare providers must ensure compliance with privacy regulations within their platforms and systems. And employ robust security measures to protect sensitive patient information during virtual consultations and electronic health record management.

Diagnostic Limitations

Certain medical conditions may require a physical examination or diagnostic tests that cannot be fully replicated in a virtual setting.

While advances in telemedicine technology, such as remote monitoring devices, can assist in some cases, there are still limitations when it comes to certain procedures, hands-on examinations, or complex diagnostic assessments.

Continuity of Care

Virtual healthcare should seamlessly integrate with traditional in-person care to ensure continuity.

Providers must have mechanisms in place to transfer patient information, share medical records, and coordinate follow-up care between virtual and in-person visits.

Effective communication and collaboration between virtual and in-person care providers are critical for comprehensive and coordinated healthcare.

Reimbursement & Insurance Coverage

The reimbursement models and insurance coverage for virtual healthcare services are still evolving.

Providers and patients may face challenges in obtaining adequate reimbursement for virtual consultations, and insurance coverage may vary depending on the type of virtual service provided. Ensuring fair and sustainable reimbursement models for virtual care is essential to incentivize healthcare providers and support the widespread adoption of virtual-first healthcare.

Provider-Patient Relationship

Building and maintaining a strong provider-patient relationship can be more challenging in a virtual setting compared to face-to-face interactions. Healthcare providers must establish effective communication channels, develop trust with patients, and address concerns related to the perceived lack of personal connection that can occur in virtual care.

Conclusion

Virtual first health plans have emerged as a transformative solution in the healthcare industry, leveraging technology to provide convenient, accessible, and cost-effective care. These plans prioritize virtual connectivity and remote consultations, allowing patients to connect with healthcare professionals anytime, anywhere.

The main advantages of virtual care like providing access to specialists or enhancing chronic disease management have made it a primary mode of healthcare delivery.

However, challenges related to access, technology, privacy, diagnostic limitations, and reimbursement must be addressed to ensure equitable and widespread adoption.

Regulatory and legal considerations are crucial in maintaining patient safety and privacy in the virtual healthcare landscape.

As virtual-first health plans continue to evolve, healthcare providers must adapt to changing care delivery models and embrace the opportunities and challenges of providing care in a virtual setting.

Overall, virtual first health plans hold immense potential to improve healthcare accessibility, enhance patient outcomes, and reshape the future of healthcare delivery.

Written by Shortlister Editorial Team

Sources

Telehealth Services

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