What to look for when adding virtual primary care to your health plan

Telemedicine had been slowly making its way into our homes for years (and arguably longer). Then, in a pandemic minute, virtual healthcare was everywhere and telemedicine took its next step: virtual primary care. 

Today, compared to the off-hours, remote, episodic online visits that once defined telemedicine, virtual primary care practices are swiftly popping up, aiming to take the place of traditional, in-person primary care. The gamut includes on-demand, one-off virtual primary care visits all the way to truly integrated practices that sit within employer-sponsored health plans.

As a clinician, I find the possibilities incredibly exciting. Virtual primary care holds great promise for addressing spiraling healthcare costs, increasing the accessibility of quality primary care and resolving other barriers around DEI and beyond. But with so many options and providers ramping up quickly, I also see the potential for enormous quality and care variations. 

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Therefore, it's imperative for employers and the brokers who serve them to understand that not all virtual primary care providers are alike: Much like in-office experiences differ, virtual primary care practices vary in delivery, quality, continuity and focus. 

So, with so many players emerging, what does "good" virtual primary care look like? And what makes it "great"? It may sound biased to say it looks like Centivo's virtual primary care practice – but that's not just my opinion. Centivo Virtual Primary Care recently became one of the very first virtual primary care practices to receive Patient-Centered Medical Home (PCMH Recognition by the National Committee for Quality Assurance (NCQA). This prestigious credential demonstrates that our practice aligns with NCQA's mission to improve efficiency and effectiveness in the healthcare system. 

With these criteria (and our experience) in mind, here are some features to look for if you are an employer considering adding a virtual primary care (or "virtual first primary care") component to your health plan offering:

A laser focus on access
Is there a fundamental focus on access? Meaning, are providers available and engaged when and where patients need them? A core benefit of a virtual primary care practice is being able to schedule an appointment without having to take off work, travel or wait in an office – patients can meet with providers from wherever they are. 

Our Centivo Virtual Primary Care medical director, Dr. Jane Sailer, points out another invaluable aspect of patient-centered virtual primary care: connecting with patients who might otherwise get lost in the system. "We sometimes see people who have been care-avoidant, who haven't been seen by a doctor in years. If we can connect with these folks and build their trust, it's an easy way for them to see a doctor and sometimes head off serious medical problems before they end up in a hospital as a first point of care."

Proof that easily and readily available primary care can enable healthier and more affordable outcomes? Centivo's 2022 healthcare spend analysis, derived from the company's flagship primary care-centered Partnership Plan offering, revealed 30% higher primary care visits as well as 15% fewer emergency room visits and 13% fewer inpatient admits, which helped result in savings of 21-33%.

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Team-based, high-touch care
While some virtual care providers make use of chatbots and artificial intelligence to quickly respond to current or would-be patients, a quality virtual primary care practice should not sacrifice a thoughtful human approach for the sake of speed. An online primary care practice can function like an in-person, neighborhood primary care physician (PCP) office when a virtual provider or team has the resources and opportunity to really get to know their patients. They can still respond knowledgeably and swiftly, but with the familiarity and care you would expect from a local, in-person practice.

Coordinated quality community care
Any virtual primary care practice will need to send patients to in-person specialists or facilities for certain health issues, vaccines, lab work or other tests. Care coordination is an essential concept for a standout virtual primary care practice, so understanding how the referral network is evaluated for quality, cost and access is a critical decision point for choosing a practice.

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Greater patient AND clinician satisfaction
Improved access and quality care go hand in hand with a better patient experience. Virtual care can be rewarding and empowering for providers as well, when they are given the resources, infrastructure and time to take thoughtful, personalized care of people. It can be as robust and effective as best-in-class in-person advanced primary care, which is a win-win for patients, providers and the system in general.

As with any fast-growing innovation, virtual primary care will see plenty of new ideas and shiny add-ons in the years ahead. And change – especially when it involves a greater focus on primary care – is a positive thing. But for any employer or broker scouting virtual primary care as part of their health plan offering, I'd suggest keeping an eye out for what's at the heart of great care: quality, access, compassionate providers and a dedicated patient-first focus.