Virtual care has come a long way since its contemporary evolution as a way to support urgent care. In an interview, Rob Bressler, general manager for Primary360, Teladoc Health’s virtual primary care solution, talked about the company’s shift from telehealth for urgent care to whole person care, including virtual primary care, and the implications of that transformation.
Bressler lists numerous challenges of in-person primary care: it’s time-consuming, wait times can be quite long, the amount of time actually spent with a physician can be very short, it can be inconvenient, and, in many parts of the country, patients live in primary care deserts leaving them with little or no access to the care they need.
“We believe there are about 100 million Americans who are not getting access to the primary care that they need, whether that’s due to inconvenience, provider access issues, or a provider shortage. These individuals are core to the problem that we’re solving and that’s the audience that we’re focused on. This is more than just an access issue. This is a health equity problem.”
The Covid-19 pandemic introduced many of us to virtual care for the first time. It was often used for follow-up appointments, especially in the early days of the pandemic. The public health emergency declaration, which expanded reimbursement by CMS, also coaxed providers to adopt and scale telehealth and make it available in different departments, especially primary care.
Teladoc Health’s Primary360 is available nationwide and members can book a new appointment within a week whereas in person appointment lead times average almost 30 days across the country. Teladoc Health’s Primary360 model directly addresses this access shortage. Initial visits are longer and can last over 45 minutes, allowing patients to build a rapport with a physician. That’s a significant change from 10 years ago, when the focus was applying telehealth to urgent care and patients would get whichever provider happened to be available. With Primary360, patients request and select specific physicians. Bressler said this option is a new way to think about how primary care is delivered and reflects a shift away from virtual as only transactional care.
“Members are routinely coming back to us and saying, ‘I want to see the same provider again.’ That relationship has value clinically,” said Bressler. “If you have a relationship with someone who you trust and who knows you and knows your care plan, you’re much more likely to adhere to that plan and come back to them.”
Primary360 also provides home delivery for prescription medication to improve medication adherence.
Virtual primary care removes a lot of inconsistencies and disparities in care, and members can get the same quality of care whether they live in a primary care desert or a major metropolitan area, across all 50 states. Marry that with the wealth of data that a company with the scale and resources of Teladoc Health.
There are several programs within the Primary360 platform. Teladoc Health’s merger with Livongo has added a whole suite of whole-person health capabilities that integrate chronic care management and mental health with primary care.
“I think that we are just scratching the surface of the promise there. We are delivering screening and prevention at scale with a high degree of throughput. We are going to treat a lot of people who have gaps in care, a lot of people who have mental health needs,” Bressler said. “Every individual that goes through our program, for example, includes a PHQ-9 and GAD-7.”
That means members are screened for depression and other mental health needs without having to get up from their desk or couch. With a shortage of mental health providers across the country, easy access to care is an enormous benefit to both the patient and to providers, he added.
As virtual-first plans build momentum among payers, Bressler pointed out that Teladoc Health’s collaboration with the payer Centene has positioned the company in the vanguard of this trend. Virtual-first plans have become a lot more common in the past three years. Teladoc Health has a partnership in the employer market with Trustmark, a subsidiary of HCSC, which administers virtual-first style plans, along with the health insurer Priority Health.
To further its focus on health equity, Teladoc Health recently launched a version of its app in Spanish and is continuing to invest in broadening Teladoc Health’s capabilities in this area to address a large unmet need in the Spanish speaking population.
With the lifting of the three-year public health emergency, virtual health companies like Teladoc Health are facing not only a new reality, but a unique opportunity to improve patients’ lives. The company is confident that its solutions can help members navigate this public health shift.
“You’re going to have millions of people rolling off of coverage, with gaps in coverage, who are going to have to go and navigate that point in their healthcare journey. They’re still going to have chronic conditions and need medication refills and need to see their specialist,” Bressler said. “Virtual primary care is the perfect solution to that problem. It is scaled to every corner of America.”
Photo: Teladoc Health