The concept of hybrid care has seemingly been everywhere since the start of the year. It showed up in a number of industry predictions for 2023, was the subject of questions lobbed at Teladoc in their most recent earnings call, and is at the root of agreements like CVS’s purchase of Oak Street Health and Amazon’s rollout of One Medical.
Part of this is because healthcare is now following the proven model of convergence in other industries like ecommerce and retail. But healthcare has its own flavor, what we like to call hybrid collaborative care.
Rather than simply acquiring or growing assets under a single brand, we are seeing a unique collaboration in areas like mental health and musculoskeletal care where distinct virtual and physical providers partner to augment their individual offerings.
All signs for this rapidly evolving formula indicate that the year ahead will be defined by a more methodical integration between the two – revealing a new breed of hybrid care combining virtual health offerings with local physician practices. Winners will be defined by the multi-channel engagement opportunities they provide to patients across online, mobile, and brick-and-mortar clinics.
Integrated Care Improves Clinical Outcomes
Along those lines, we expect to see more deals like UnitedHealthcare’s new virtual Center of Excellence initiative in the coming months. This is largely because the evidence for better clinical and economic outcomes with hybrid collaborative – or wrap-around – care solutions is overwhelming. Our own experience in digestive health serves as a helpful model.
Digestive disorders are very common and have a high economic burden, affecting more than 70 million people in the U.S. – more than diabetes or heart disease – and driving more than $135 billion in annual healthcare costs. A recent clinical trial testing whole-person, multidisciplinary care showed that patients reported 98% satisfaction, 89% improvement in quality of life and 92% reported symptom improvement. Patients also reported 1.3 fewer missed workdays per month and demonstrated lower healthcare utilization including a 64% reduction in GI-related emergency department visits.
But that holistic, extended approach is impossible for traditional clinics to deliver on their own because they are overwhelmed by patient demand for appointments and testing. And because they are not reimbursed for non-core services like dietary advice, behavioral health services and coaching, which makes it impossible to staff up on their own. On the flip side, virtual care providers are ideally suited to deliver these integrated care solutions and services, but not to examine patients or conduct procedures that can only be done in person.
The answer lies in hybrid collaborative care. Virtual care solutions can take the pressure off GI clinics, allowing them to eliminate patient back-logs, focus on critical care needs, and lean into their core offerings of diagnostic testing. At the same time, virtual care solutions provide a great source of referrals for clinics.
This is especially relevant for patients from rural areas and mid-sized cities who are suffering from a chronic condition. While rural communities experience a higher prevalence of chronic conditions than their urban counterparts they have less access to care. With patient-to-primary care physician ratios in rural areas hovering around 40 physicians per 100,000 people, and specialty care access even worse, hybrid collaborative models utilizing virtual access can bridge this supply-demand gap and mean the difference between suffering and thriving.
Policymakers and Clinicians Embrace Collaboration
The marketplace is aligning to smooth this transition. Consider the CMS Interoperability and Patient Access rule that continues to evolve. By requiring more seamless data exchange amongst providers and payers, it breaks down industry silos and paves the way for more hybrid collaborative treatment regimens and partnerships. The Biden Administration also recently extended the waivers for telehealth and hospital-at-home programs through the end of 2024 as part of the recent spending bill signed into law.
Importantly, there has also been a change in the industry’s attitude towards these virtual offerings. Traditional clinics, initially skeptical of virtual care providers as new competition, have increasingly realized the benefits of partnering. A recent survey found that 64% of practice-based physicians and 66% of hospital executives believe telehealth leads to more comprehensive quality care.
We are seeing providers launching virtual health programs, payers expanding coverage for virtual care solutions, and employers seeking new virtual health partners for their workers. Patients, too, are eager to engage a hybrid offering for their care needs, with 60% planning to pursue a mix of in-person and virtual care for reasons of access, convenience, and expanded offerings.
Follow the Money to Collaborative Hybrid Care
Critical to long-term adoption, the economics also support this hybrid collaborative model. More Americans are living with chronic or multiple chronic conditions, and it’s expensive for providers, payers and patients engaged in these courses of treatment. The Centers for Disease Control and Prevent estimates that 90 percent of annual healthcare spending is for treatment of chronic diseases. In many cases – whether for digestive, musculoskeletal or other chronic concerns – multidisciplinary care is most effective at managing and treating symptoms.
Not only do chronic conditions beg for hybrid collaborative care solutions, but value-based care goals align with hybrid collaborative care treatments and outcomes. By favoring preventive, effective interventions earlier in the care continuum, hybrid collaborative care can help deliver higher patient satisfaction and better outcomes more efficiently. And at a time when hospitals and providers are under macro-economic pressure and facing worker and physician shortages, hybrid collaborative care offers a way to extend services, increase patient volume and clear practice logjams.
For all of these reasons, we will see more brick-and-mortar clinics and payers partnering with virtual care platforms in 2023 and vice versa. We know that face-to-face care will always have a pivotal role in care delivery, but we also know from experience that virtual care provides more intentional, cost-effective and impactful approaches to care. The two care models need to evolve together to meet patient demand for flexible, affordable, effective care.