Hybrid care options are key to members managing their health

Virtual care adoption has skyrocketed over the last few years and has become a mainstream solution in care delivery. Our latest research shows that 58% of privately insured consumers stated that they have used virtual care in the past 12 months.

In partnership with Ipsos, Evernorth conducted a nationwide survey of more than 3,600 consumers, employers and health plan leaders to understand the challenges at the forefront of health care today. This valuable data targets specific concerns plan sponsors should keep in mind to stay ahead of market dynamics that have a potential impact on their members and plans.

Our market research identified three key insights in our 2023 Health Care in Focus report, one of them being about evolving hybrid care expectations.

Hybrid care options are becoming more common

When asked about the circumstances that would justify using virtual care instead of in-person care, consumers supplied a variety of responses. 46% said that it made more sense to switch to virtual care for convenience, especially when they are able to receive care from the comfort of their own home. 44% stated they used virtual care for mild symptoms and 42% claimed that they chose to go virtual because it helped lower costs.

Hesitation still exists towards hybrid health care

According to a 2023 Buyer Research conducted by MDLIVE, hybrid care is not yet a category recognized broadly. While there are many definitions floating around, buyers define hybrid care as data flowing across care modalities, namely, in-person and virtual. Ultimately, the primary goal of hybrid care is to improve access and deliver care where members are. That said, some members are still hesitant about adopting a hybrid care setting, despite plan sponsors' significant investment in the hybrid care model.

Half of respondents actually expressed perceiving diminished quality of care outside of hospitals and providers’ offices. Nevertheless, plan sponsors remain less concerned, with only 32% of employers and 39% of health plan leaders sharing consumers’ opinion.

Patient satisfaction with virtual care remains high

Despite these concerns, the members that do engage in virtual care expressed a high degree of satisfaction with their experiences. Four clinical disciplines earned especially high grades:

• 94% Primary care
• 91% Urgent care
• 91% Specialists
• 90% Mental health counselors or therapists

Plan sponsors need to help members navigate virtual care benefits

59% of respondents said they need more help knowing what is covered by their insurance. That said, the most significant challenges for plan sponsors involve overlapping benefits. 56% of consumers stated that they are frustrated with navigating the various care, benefit and vendor offerings. Moreover, 62% of employees find it difficult to know when to use which benefit offered by their employers. If consumers are unable to find the care they need, health concerns can go unaddressed, leading to adverse events and more serious, more costly conditions. It will be essential for plan sponsors to amplify benefit education efforts for a better, more unified health care experience.

Other key takeaways for plan sponsors include:

• Digital triage is a strong point of difference. It helps improve member navigation and get patients to the right site of care
• Coordinate initiatives to improve awareness. Plan sponsors can help to educate consumers, informing them about all the care options available to them, including both virtual and brick-and-mortar care.
• Education efforts will be critical. Arming consumers with the information required to access the care they need results in greater productivity, better outcomes and a more cohesive experience.
• Adopt growing technology options. Provide members with a stronger connection to their health by offering care options at the care settings they want - both virtual and in-person.

Click here to access the full 2023 Health Care in Focus report.