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The Future of Healthcare is Virtual: How Payers Can Navigate the Booming Industry

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The Future of Healthcare is Virtual: How Payers Can Navigate the Booming Industry

By Lucia Savage


If you are a payer, would you want the hospitals in your network to not be accredited by the Joint Commission on Accreditation of Healthcare Organization (JCAHO)? What about your physician network? Do you want board-certified specialists? How about healthcare professionals who adhere to evidence- based medicine best practices, for instance, not prescribing antibiotics for colds caused by viruses?

These are the fundamentals to look for in both your brick-and-mortar and virtual-first digital healthcare providers. In fact, baseline evidence bears up to scrutiny that a virtual-first delivery method yields the same or better health outcomes as traditional healthcare. Today, a growing number of virtual-first healthcare providers are taking it upon themselves to meet and exceed the established quality standards of traditional healthcare. For example, in 2021, Omada earned the National Committee for Quality Assurance’s (NCQA) Population Health Accreditation, the first all-digital, virtual-first healthcare provider organization to do so.

A growing number of virtual-first healthcare providers are taking it upon themselves to meet and exceed the established quality standards of traditional healthcare.

As insurance companies or self-insured welfare benefits plans think about the rise of virtual-first care in a post-covid world, with thousands of digital care offerings to choose from, what should be top-of-mind? Four considerations rise to the surface:

1. Real-World, Real-Time Evidence: Maximizing the use of digital tools to generate real-world, real-time evidence of how the individual’s health is being maintained.

2. Software Stacks Grounded in Interoperability: A modern software stack coupled with a health information philosophy grounded in interoperability and improved understanding, so that all parts of the individual’s healthcare team have appropriate information.

3. Member-First Shared Care Planning: The ability of virtual-first care to meet the member where they are, with minimal delays, and more opportunities for shared care planning between the individual and their care team.

4. Scale and Care Team Consistency: Virtual-first care enables broader geographical reach and accessibility to members, leading to consistency of care.

In this white paper we look at each in turn. Download to learn more.