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Opportunity created: The need to keep virtual care as a cornerstone of health models

An opinion piece

Dr. Bernie Elliott, chief medical officer, UnitedHealthcare Global
January 2022

What a drastic difference 18 months can make! SARS-CoV-2 and the resulting COVID-19 pandemic has made us rethink how we do almost everything, and nowhere has that been more apparent than in the delivery of health care. Almost overnight, virtual care went from being a niche capability to a mainstream necessity, catapulting the last vestiges of traditional medicine squarely into the digital 21st century.

Preceding the pandemic, virtual health was struggling to gain traction. Regulations in many geographies restricted or, in some cases, prohibited telemedicine. If a country or region did allow it, provider adoption was slow. Where virtual care was available, it often only addressed intermittent, acute care needs and lacked continuity. Patients were hesitant to try something new, especially if the hurdle to access virtual care was high, or if they couldn’t see their own doctor. Payers were often equally hesitant to wade into this new frontier, struggling to understand how virtual health impacts quality and total cost of care, while fearing the Pandora’s box that could open new channels for fraud, waste, and abuse. In between, payers and providers debated the merits of reimbursement parity.

COVID-19 changed everything — it was truly the perfect storm. Amid the surge in COVID-19 patients across the world, and the resulting government shutdowns to mitigate the spread, hospitals were being overwhelmed. People with acute and chronic conditions alike were not seeking needed care. In this new paradigm, regulators loosened restrictions on virtual health and payers adjusted benefits to make access easier. Simultaneously, providers scrambled to add digital care capabilities to their practices, and hospitals needed to completely rethink how they could be more efficient during the influx of COVID-19 patients, while helping those needing care for other conditions to feel safe doing so. Suddenly, virtual access to care became a top priority, and key stakeholders across the health system aligned to make it a reality.

The pandemic has ushered us into a new age in medicine, and no doubt many of the rapid gains that we have seen in virtual care are here to stay. More than a year into the pandemic, consumer use is holding steady at around 20%, and it has opened much-needed venues for greater access, such as care for mental health conditions — a growing pandemic itself in the post-COVID-19 world. Virtual health should be here to stay. Almost every other consumer-driven sector has successfully embraced technology to make access easier and simpler while delivering greater value to all stakeholders. Virtual delivery of care should be no different. It is simply another tool in the toolbox, and like any other modality in health care, if used appropriately, it will deliver value across the quadruple aim while helping to solve long-standing problems with access and health inequities.

But as we embrace the many benefits, we also must address the challenges. Virtual care should be integrated across the care continuum and not simply bolted on to our existing care models. Like in-person care modalities, we should follow the same standards in using data and evidence to measure outcomes, quality, cost, patient safety, fraud, consumer experience and other important measures of value. As Benjamin Franklin so aptly noted, “Out of adversity comes opportunity.”  The opportunity to modernize our health care delivery system is here and now.

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