Editor’s note: Kelly Bliss is president of U.S. Group Health at Teladoc, the biggest virtual care company in the U.S.
It was a busy enrollment season for Medicare. While you may have seen commercials featuring retired NFL quarterbacks talking about vision and dental benefits, what was truly remarkable is how many Medicare Advantage plans dramatically increased their deployment of telehealth solutions for seniors. While some in the healthcare industry may be skeptical of telehealth’s utilization, particularly within the Medicare population, these plans continue to move full steam ahead.
At Teladoc Health, we work with more than 50 MA partners, and over 9 million MA beneficiaries have access to one or more of our virtual care offerings. We’re seeing continued growth in the number of plans offering virtual care services as well as expansion in the types of services being offered.
The current state of virtual care for those 65 and older
Before the pandemic, regulatory barriers kept Medicare utilization of telehealth artificially low, at 7%. In the second quarter of 2020, utilization skyrocketed to 47% of all Medicare fee-for-service members, according to CMS data. This number has remained high, with 19% of Medicare fee-for-service beneficiaries using telehealth in the first quarter this year. When barriers are removed, it’s clear that a large portion of seniors prefer the convenience of virtual care.
Looking at our own rates for MA members, we see utilization rates are up 54% for virtual urgent care services and 635% for virtual mental health services when compared to 2019.
The rise in adoption for chronic care services is even more dramatic if you consider that more Medicare members are using our chronic care services each month than all other service providers combined for remote patient monitoring services billed as part of the Medicare FFS program.
These datapoints demonstrate that any national reduction in telehealth utilization is not a demand issue, but rather a supply issue resulting from brick-and-mortar providers forcing members to return to in-person visits.
Some of the most rapid adoption of virtual solutions for MA plans has been driven by a focus on improving star ratings as more care has shifted into the home.
Early in the pandemic, several MA plans launched our diabetes and hypertension management programs as a means to boost the Stars measures tied to those chronic conditions. These efforts paid off as average performance of our partners on the triple-weighted blood pressure control and HbA1c control measures was five stars.
What drives senior engagement with virtual care?
We’ve conducted extensive user research to better understand how to engage older adults and drive continued adoption of virtual care services. Multi-modal communications and targeted marketing of specific features can drive initial and sustained engagement with digital tools.
For example, our default Medicare communication journey for chronic care combines live telephonic outreach from our call center team in addition to more traditional channels like direct mail and email. We’ve seen significant improvements in feature utilization by continued A/B testing, leveraging member communications, explainer videos and product optimization. One of our large MA plans saw a dramatic increase in coaching utilization and food logging for its diabetes prevention program.
Members that joined the program in 2022 are five to seven times more likely to use food logging and live coaching than members that joined in 2021. We believe this increase is directly attributed to the product enhancements made between the cohort launches.
Trends to expect in 2023
Knowing what I know now, what do I think will happen next year?
First, I believe we’ll see a move from transactional telehealth to telehealth for longitudinal care — in other words, growing adoption of virtual primary care physician models. Most Medicare beneficiaries have used telehealth, and we’re seeing strong interest from MA plans in the virtual primary care models popular for the exchange and fully insured markets. These models are ideal for targeted populations within MA like “snowbirds,” rural populations, those with transportation barriers or mobility issues, as well as those that yearn for convenience, flexibility and expanded visit times.
Second, I think even more aggressive interventions are needed to maintain or improve star ratings. We saw this year massive drops in star ratings for some of the largest plans. Relying on bricks and mortar networks is not sufficient to be a four+ star plan in this new environment. Plans need to leverage every tool available including virtual chronic care management programs, widespread and convenient access to virtual services, at-home testing and virtual primary care.
One thing is certain: When offered virtual care options, Medicare members are increasingly willing to engage, and engagement yields significant benefits for both the member and their plan.