Virtual care is making the leap from urgent care to primary care, a move that could lead to lower cost plans from payers.
Virtual care just took a giant leap into the realm of primary care. As MDLIVE rolls out a new primary care platform, Cigna signed on to make the service available to 12.5 million of its members. The initiative was announced at the J.P. Morgan Healthcare Conference taking place this week in San Francisco.
While the platform offers broad capabilities, including the opportunity to select and develop an ongoing relationship with a virtual primary care physician (PCP), Cigna will begin using it in the second quarter of this year to enable certain members to conduct virtual annual wellness visits. Cigna has been using MDLIVE to provide urgent care services to its members since 2014 and expanded the relationship this month to include virtual behavioral health services.
Numerous factors drove development of the new MDLIVE platform, including a shortage of practitioners, costs savings experienced by customers using its platform for urgent care—and patient satisfaction with those services—and physician burnout, says the company's CEO Rich Berner.
Cigna's hope is that more customers will complete annual wellness visits now that they are more convenient, Berner says, and "that's going to help get out of reactive care and into proactive, predictive health management and care." The wellness screenings will be available to Cigna customers 18 years and older enrolled in employer-sponsored plans.
While "it's early days" with MDLIVE's virtual primary care platform, Berner says he views Cigna as "one of the disruptors in healthcare. It's a signal to the rest of the industry that they're creating the next generation primary care experience."
Annual wellness visits are only one example of the capabilities of MDLIVE's new platform, says Berner. Comprehensive primary care, including preventive care and chronic care disease management can be provided by MDLIVE's virtual PCPs. The design is flexible, enabling customers to select options so their members can chose an exclusive relationship with an online primary care provider, retain their current PCP and occasionally use a virtual PCP—for example, if they can't get a quick appointment with their doctor—or, limit primary care to certain services, such as wellness exams.
Clients, such as health systems, can chose to use MDLIVE PCPs, set up their own PCPs on the virtual care platform, or use a combination of both. The platform enables online physicians to share records with the patient's regular physician.
The virtual primary care platform is "an extension of the great results we're seeing in urgent care," says Berner. According to one three-year study Cigna conducted that measured costs for members who used the virtual urgent care service compared to those who did not, medical costs were 17% lower for those who went online first, he says.
Berner says he expects the development of virtual primary care platforms to impact payer plan designs, possibly with lower premiums for those who chose virtual PCPs.
"They're trying to incent behavior to go online first," he says, "so they'll come out with health plans where you will get lower premiums if you choose a [virtual] primary care doctor."
MDLIVE's chatbot, Sophie Health Monitoring, is also integrated into the virtual primary care platform. Sophie uses artificial intelligence to streamline registration, triage, and scheduling. In the future, Berner says that AI and machine learning will integrate more deeply into physician workflow to further optimize care and enhance the patient experience.
“[Cigna] is creating the next generation primary care experience.”
Rich Berner, MDLIVE CEO
Mandy Roth is the innovations editor at HealthLeaders.
The platform enables patients to build an ongoing relationship with a virtual primary care provider.
Cigna will offer virtual annual wellness visits to many of its members beginning next quarter.
Payers could create plans with less expensive premiums if members chose a virtual primary care provider, says MDLIVE's CEO.