Webinar Recap: Strategies to Remove Barriers to Care

April 02nd, 2024

Did you know that nearly half of Americans haven’t seen a primary care provider in the last year? With this in mind, we asked Captive Resources’ Vice President of Strategic Vendor Relations, Kelly Garrett, to shed light on the different types of virtual and advanced primary care strategies employers should be aware of in our recent Health Risk Management webinar.

Continue reading for a recap of Garrett’s presentation.

Current State of Primary Care in the US

To kick off our recent Health Risk Management webinar on virtual and advanced primary care strategies, Garrett presented several need-to-know facts about the current state of primary care in the United States. Consider the following:

  • 46% of Americans haven’t seen a primary care provider in the last year.
  • 52% of the US population lives in an area with a shortage of primary medical service providers.  
  • Only 29% of physicians have arrangements for after-hours or weekend care other than automated phone referrals to the emergency department, leading to higher emergency room utilization.
  • Patients with access to 12+ hours of after-hours care per week are associated with 20% less ER utilization.

While telemedicine has helped improve access to care, it is coupled with limitations. Below, we dive into traditional telemedicine and additional primary care strategies available to employers today.

Traditional Telemedicine

According to a 2022 Survey of National Employer-Sponsored Health Plans from Mercer, four out of five employers currently offer traditional telemedicine. These services are often offered through the employer’s plan carrier or Third-Party Administrator (TPA) partnership.

While traditional telemedicine can solve urgent needs, these services can present several challenges:

  1. While traditional telemedicine is often convenient and easy to access, it can deter patients from building a relationship with a primary care provider.
  2. Traditional telemedicine generally lacks continuity of care or access to the patient’s full health history.
  3. Traditional telemedicine typically offers no navigation or follow-up on referrals if in-person care is needed.

These challenges have prompted employers to look for different approaches to traditional telemedicine and primary care.

Understanding Different Approaches

During the webinar, Garrett discussed three alternative approaches to traditional telemedicine.

No. 1: Acute/Urgent Virtual Primary Care

This solution is an enhanced version of traditional telemedicine and is focused on text-based care with the goal of increasing the efficiency of care for acute/urgent needs (ear infection, sore throat, etc.). This type of care eliminates the need for broadband access, and patients can often connect with a physician in under a minute.

No. 2: Virtual Primary Care

Virtual primary care expands outside the borders of traditional telemedicine and acute/urgent virtual primary care. Through virtual primary care, patients can virtually see the same primary care provider for continuity of care. The patient’s primary care records are kept on file, so if their regular primary care physician is unavailable, the attending physician can access the patient’s history. Vendors in the virtual primary care space often offer other solutions, such as virtual behavioral health and diabetes management, that can be bundled into the employer’s plan.

No. 3: Advanced Primary Care

Through advanced primary care, patients receive care in a brick-and-mortar setting, with virtual telemedicine available to help supplement in-person care. These brick-and-mortar facilities are either directly owned by a vendor or in a network of direct primary care practices. Patients receive an enhanced experience with same-day availability and longer visit times.

Choosing the Best Option

According to Garrett, employers must determine their overall goals and objectives when exploring primary care strategies. Then, it’s important to do the research and figure out what vendor best suits your company’s needs. Here are some other questions Garrett recommended considering:

  • What are your current barriers or pain points?

Consider the following questions: Are your wait times too long? Are you receiving appropriate support and resources? Is the level of care you’re receiving meeting your needs?

  • What does your budget look like?
  • What is the geographic location of your employees?

In other words, are your employees in an area where they could utilize in-person care services?

  • What is the vendor’s NPS score?

A vendor’s Net Promoter Score (NPS) can say a lot about the quality of service they provide.

When implemented correctly, primary care strategies have the potential to greatly improve employees’ healthcare experience while also improving overall healthcare spend.

About the Webinar

This presentation was part of Captive Resources’ Medical Stop Loss Webinar Series — regular installments of webinars to educate medical stop loss group captive members. The thoughts and opinions expressed in these webinars are those of the presenters and do not necessarily reflect Captive Resources’ positions on any of the above topics.

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