The COVID-19 pandemic took telehealth mainstream, making virtual
In January, the carrier launched its virtual-first health plan, Virtual Blue, which will officially go into use on April 1. Featuring no co-pay or deductible charges, its services include pediatrics and family medicine, along with integrated mental health care, 24/7 urgent care and care in over 20 specialities like cardiology, dermatology, rheumatology and infectious disease. The employer-provided plan comes with physical vitals kits so members can reliably check metrics such as their temperature and blood pressure from home. If a member needs in-person care, they can access Blue Shield's PPO network at typical PPO costs.
Since Virtual Blue members can access a variety of providers, regardless of where they live or their immediate finances, the plan is designed to expand healthcare access across California, explains Dr. Nina Birnbaum, medical director of innovation acceleration at Blue Shield of California.
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"Your geography or who you are shouldn't limit who you can pick as your healthcare provider," she says. "Whether you live in a city or in a rural place, or want a person who matches your ethnicity, you should be able to find a provider who matches your criteria."
Notably, Blue Shield primary care providers are made up of over 60% women and approximately 40% Black and Indigenous physicians. Members can also choose physicians with experience treating LGBTQ-identifying patients. Now with Virtual Blue, Dr. Birnbaum hopes more members can take advantage of that diversity.But she underlines that it wasn't enough to have an expansive and virtual primary care network — Blue Shield wanted to create a virtual healthcare system of its own.
"Often employers are the ones trying to piece all these [virtual] point-solutions together into something that makes sense," says Dr. Birnbaum. "So we took on the challenge of creating a health plan that doesn't require additional point solutions glued onto it."
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This meant ensuring that after visiting with a primary care physician, patients could easily be connected to their next point of care while still using
While Virtual Blue boasts no upfront costs, Dr. Birnbaum predicts long-term savings for members as well, given that easy access to primary care providers and specialists will help catch and treat preventable diseases early. In fact, researchers from the California Health Care Foundation suggested that further investment in primary care access could eliminate 25,000 acute hospital stays and 89,000 emergency room visits, saving $2.4 billion in overall healthcare spending in a year when just accounting for about half of California commercially insured adults.
"There's a lot of research showing that strong primary care provides higher quality and lower cost care overall to the healthcare system," says Dr. Birnbaum. "So we knew if we built in a really strong primary care base, we could manage people's chronic health conditions over time so that they didn't deteriorate and end up having to get emergency care."
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And ultimately, employers and employees want health plans that are affordable and effective. A health plan could make or break an employer's ability to recruit and retain their best talent, and in the face of rising healthcare costs and labor shortages across the U.S. healthcare system, employers will need more than a table-stakes insurance plan, regardless of whether they work with a carrier or are self-insured.
"Our motto at Blue Shield is to create a healthcare system worthy of our family and friends," says Dr. Birnbaum. "We are thinking about how we can really take the lessons of virtual care and apply them so that they can be broadly used to benefit a commercially insured population."
