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The Future of Virtual Care Services: A Payor's Perspective
Jay Rajda1, Harold L Paz1,2
1Aetna, Inc., New York, New York.
Summary
Virtual care models offer significant potential for managing chronic conditions, improving access for complex patients. As reimbursement policies evolve, expect wider physician adoption and increased patient access to these essential services.
Area of Science:
- Healthcare delivery innovation
- Digital health technologies
- Chronic disease management
Background:
- Current telemedicine predominantly addresses minor acute conditions.
- Significant potential exists in virtual care for complex chronic condition management.
- Continuity of care and in-person evaluations are crucial for effective virtual chronic care.
Purpose of the Study:
- To explore the potential of virtual care models in improving access to chronic condition management.
- To identify key considerations for providers and consumers in the evolving landscape of virtual care.
- To analyze the impact of evolving reimbursement policies on the adoption of virtual services.
Main Methods:
- Analysis of current telemedicine service models.
- Review of regulatory trends in virtual service reimbursement (e.g., Center for Medicare and Medicaid Services).
- Discussion of operational, logistical, and clinical factors for virtual care implementation.
Main Results:
- Virtual care models are poised to enhance chronic condition management for complex individuals.
- Favorable reimbursement trends are driving growth in virtual service availability.
- An inflection point is approaching, leading to broader coverage and increased physician offering of virtual services.
Conclusions:
- The evolution of virtual care presents a significant opportunity to improve chronic disease management.
- Provider readiness and consumer education are essential for successful virtual care integration.
- Anticipate substantial growth and increased physician participation in virtual care delivery.