January 29, 2021

Regional Health Plans Going Virtual

Regional health plans like Priority Health, Oscar, Harvard Pilgrim and others emphasize “virtual-first” health plans to attract tech savvy younger members and those with limited transportation, time, and child care. The plan design typically requires a telehealth consultation prior to an in office visit and other digital alternatives. The idea is to reduce costs by altering setting and reimbursement rates, requiring co-pay only initial visit payments by members and the reduction of admin costs. This type of plan may also increase member satisfaction scores and result in better outcomes based on members seeking a consultation rather than waiting to go into the office until after the situation has grown worse.