Virtual Care and Master Stars: Value for Seniors and Health Plans

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Editor’s note: Kelly Bliss is president of US Group Health at Teladoc, the largest virtual care company in the US

It’s been a busy Medicare enrollment season. While you may have seen ads featuring retired NFL quarterbacks talking about the vision and dental benefits, what has been truly remarkable is how many Medicare Advantage plans have dramatically increased the adoption of telehealth solutions for seniors. Although some in the health care industry may be skeptical about the use of telehealth, especially among the Medicare population, these plans continue to be full steam ahead.

At Teladoc Health, we work with more than 50 MA partners and over 9 million MA beneficiaries have access to one or more of our virtual care offerings. We are seeing continued growth in the number of plans offering virtual care services, as well as an expansion in the types of services offered.

The current state of virtual care for those 65 and older

Before the pandemic, regulatory barriers kept telehealth use in Medicare artificially low at 7%. In the second quarter of 2020, use rose to 47 percent of all fee-for-service Medicare members, according to CMS data. That number remains high, with 19% of Medicare fee-for-service beneficiaries using telehealth in the first quarter of this year. When the barriers are removed, it’s clear that a large majority of seniors prefer the convenience of virtual care.

Looking at our own rates for MA members, we see that utilization rates have increased by 54% for virtual emergency services and 635% for virtual mental health services compared to 2019.

Main photo of Kelly Bliss, President of the US Healthcare Group at Teladoc

Kelly Bliss, president of the US healthcare group at Teladoc

Permission granted by Teladoc Health

The increase in uptake of chronic care services is even more dramatic when you consider that more Medicare members use our chronic care services each month than all other service providers combined for billed remote patient monitoring services as part of the Medicare FFS program.

These data points indicate that any national decline in telehealth use is not a demand problem, but rather a supply problem stemming from brick-and-mortar providers forcing members back to in-person visits.

Some of the fastest adoption of virtual solutions for MA plans is due to a focus on improving star ratings as more care is shifted to the home.

At the start of the pandemic, several MA plans launched our diabetes and hypertension management programs as a means to strengthen Stars measures related to these chronic conditions. These efforts paid off as our partners’ average performance on the triple-weighted blood pressure control and HbA1c control measures was five stars.

What drives seniors’ engagement with virtual care?

We conducted extensive user research to better understand how to engage older adults and encourage continued adoption of virtual care services. Multimodal communications and targeted feature-specific marketing can drive initial and sustained engagement with digital tools.

For example, our Medicare default communications journey for chronic care combines live telephone outreach from our call center team in addition to more traditional channels such as direct mail and email. We’ve seen significant improvements in feature usage through continued A/B testing, use of member messaging, explainer videos, and product optimization. One of our large MA plans saw a dramatic increase in the use of coaches and food enrollment for its diabetes prevention program.

Members who joined the program in 2022 were five to seven times more likely to use food logging and live training than members who joined in 2021. We believe this increase is directly due of product improvements made between cohort releases.

Expected trends in 2023

Knowing what I know now, what do I think will happen next year?

First, I believe we will see a shift from transactional telehealth to long-term care telehealth—in other words, increasing adoption of virtual physician models for primary care. Most Medicare beneficiaries have used telehealth, and we are seeing strong interest from MA plans in the virtual primary care models popular in the exchange and fully insured markets. These models are ideal for MA target populations such as “snowbirds”, rural populations, people with transportation barriers or mobility issues, and those who crave convenience, flexibility and extended visit times.

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