Deloitte: Alternative Care Sites Provide Solutions to Several Healthcare Problems

Alternative care sites can address several challenges, including boosting access for underserved populations and increasing mental health services.

Alternative sites of care offer several opportunities for healthcare organizations and their patients, according to a new report published by Deloitte.

Alternative sites of care include retail clinics, mobile units, telehealth, community health centers, and care in the home such as hospital at home and outpatient care in the home. Alternative sites of care are not new, but they are a growth area with advantages over traditional doctor's offices such as the ability to improve the consumer experience.

A co-author of the report, Jay Bhatt, DO, MPH, MPA, executive director of the Deloitte Center for Health Solutions and Deloitte Health Equity Institute, told HealthLeaders that alternative sites of care are geared toward serving increasingly empowered healthcare consumers.

"There is a premium on getting closer to patients and providing personalized service as well as meeting patients where they are. By creating more access points, we can support consumer experience, including opportunities to address the drivers of health that directly influence health outcomes. By understanding what consumers need for today and incorporating the range of perspectives that are provided by alternative care sites, organizations can shape better strategies to connect with consumers, build trust, and have a better healthcare experience," he said.

The report is based on survey data collected from a nationally representative sample of more than 4,500 consumers in February and March 2022. The report also includes data collected from online focus groups with more than 400 consumers who identified as Black, Hispanic, Asian, and Native American.

Boosting access for underserved populations

Alternative care sites can improve healthcare access for underserved populations, the report says. "Alternative care sites can help make care more equitable and accessible by providing more patient touch points and expanding the location options for well visits, mental health care services, and so much more. Our survey findings show that retail clinics, virtual health, and community health centers could bridge care delivery gaps for populations that have been historically underserved," the report says.

Alternative care sites have tremendous potential to provide care to underserved populations, Bhatt said. "Alternative care sites can offer more convenient, accessible, and equitable care. We know that there are challenges in getting to traditional care sites. There are issues related to trust, stigma, transportation, and people's lives such as if they are working multiple jobs."

Virtual visits are an emerging area to provide medical services to underserved populations, he said. "At Deloitte, we have seen in our data that many consumers are willing to use virtual health, which would help address gaps in care. Nearly three in four consumers with Medicaid or health insurance exchange plans would use virtual health for mental health visits, for example. More urban consumers would use virtual visits for preventive care. Nearly two-thirds of consumers would use virtual visits for medical care among all races and ethnicities."

Building trust by connecting patients to diverse care teams

Alternative care sites are an opportunity for healthcare organizations to build trust with patients from ethnic and racial groups who feel disaffected with healthcare providers, the report says. "Alternative care sites—if staffed with diverse and empathic care teams—could be opportunities for healthcare organizations to connect with their consumers and rebuild trust. One step to rebuilding trust is employing clinicians and care teams who look like, have shared experiences, and demonstrate empathy toward the communities they serve."

Staffing alternative care sites with diverse care teams is crucial to building trust, Bhatt said. "We have seen in our data in this report that two out of three participants who identify as Black, Asian, or Hispanic descent would like to see healthcare providers who are similar to them—either in race or lived experience. So, consumer and community trust in healthcare providers and organizations is critical for optimal health. Trust influences patients' willingness to get medical care, preventive screenings, and mental health care. We have seen data that shows trust links to improved patient experience, health outcomes, and perception of the care that patients receive."

Improving access to mental health services

Virtual health and other alternative care sites are an opportunity to boost access to mental health services, the report says.

"Virtual visits could be a way for increasing access to mental health care, particularly for individuals in communities where stigma is high. Virtual health could provide access to a clinician who has a shared background or lived experience that an individual may not be able to see during an in-person visit. … Retail clinics, community health centers, or virtual health apps that can feel like a safe and accessible way for individuals to access care could fill a much-needed gap for consumers who want mental health treatment," the report says.

Alternative care sites are part of the solution to increasing much needed mental health services in the country, Bhatt said. "About 50 million adults in the United States experience some type of mental illness, yet more than half of these people do not receive treatment. Access is uneven across the United States, with 37% of Americans living in a mental health provider shortage area. So, we must think about different ways of approaching care delivery, and alternative care sites are an important answer to those challenges."

Meeting consumer demand for convenience and transparency

Alternative care sites are effective in providing convenience and transparency to patients, the report says.

"Consumers' desire for convenience is well-known, but important—and we need to solve for it because consumers are increasingly expecting a healthcare experience that feels like experiences in retail, banking, and other industries. … Another component of a positive patient experience is transparency. In our 2018, 2020, and 2022 consumer surveys, consumers said 'having clear explanations of costs' was the best indicator of a good patient experience in healthcare. Retail clinics and therapy apps tend to provide fixed and transparent pricing, and most accept insurance/Medicare, which is not necessarily true among more traditional providers," the report says.

Convenience is a primary reason why patients use virtual health, Bhatt said. "Convenience is driving healthcare consumers to virtual health visits. We found convenience is the Number One reason patients use virtual health."

Alternative care sites often provide a higher degree of transparency for patients than traditional doctor's offices, he said. "We know that alternative care sites that offer transparency and a safe space can influence consumers to make better healthcare decisions. For example, we do not have consumers flying blind in grocery stores or other locations shopping for consumer goods without having transparency about price and what they are getting. We should think about transparency in the context of healthcare services and more and more of that is happening at alternative care sites."