Why Amwell is urging payers to embrace full digital care delivery

Cathy Hartman is the general manager of payor commercialization and marketing at Amwell. She sat down with Becker's to discuss how payers are poised to move healthcare beyond traditional telehealth and improve clinical outcomes through full digital care delivery.

Formerly with BCBS of Massachusetts, she now oversees 55 health plan clients for one of the nation's largest virtual care companies, including UnitedHealth Group, Elevance Health, CVS/Aetna and large BCBS affiliates.

Question: Telehealth obviously boomed at the peak of the pandemic. How would you describe where utilization is trending today?

Cathy Hartman: We've really expanded our suite of offerings beyond traditional urgent care and behavioral health. More and more we have clients adding virtual primary care and really branching into longitudinal care with things like digital physical therapy and dermatology. With that expansion beyond traditional urgent video visits, we're actually seeing more utilization.

Q: You were formerly chief product officer at BCBS Massachusetts. Why is continued telehealth investments and expansions a good idea for all insurers?

CH: A lot of it has to do with before the pandemic. Certainly, when I was at Blue Cross Massachusetts, we talked a lot about when that tipping point will come where telehealth becomes a new care delivery model —  a new site of care as opposed to part of a benefit design. Then, obviously, COVID was that tipping point. 

As we're here post-COVID, the spikes in utilization are leveling out and it sounds like some populations are decreasing. But what we gained from that, both provider and consumer, is willingness to use telehealth for virtual visits. We're really poised to expand way beyond telehealth — as Amwell sees it, a full digital care delivery. We're thinking about how we can be a platform enabler to that digital care delivery. That's why I think the increased opportunity or justification for investing in this area is really moving beyond telehealth to digital care, which for me means expanding beyond urgent and episodic to more whole-person, longitudinal care. I know that the whole-person term is a bit of a buzzword and it's overused, but it really does mean supporting members across that whole journey from urgent to primary.

The other opportunity is really improving new care models to impact outcomes. By that I mean blending telehealth and video visits with more in-person care so that you've got support, adherence and always-on capabilities between visits.

Q: Telehealth can provide a lot more than just traditional video calling. What do you believe is the untapped tech in this field?

CH: There's a lot of interesting tech out there with some of the automated care capabilities. We recently had the strategic acquisition of Conversa so that we could build in always-on automation. The outcomes that we've seen with that goes way beyond engagement — it's the ability to have intake screeners include behavioral health before every visit so that you've got our integrated behavioral health model and ability to address that with comorbidities and chronic conditions. More importantly for the post-visit follow up, we're able to put people into digital care programs that drive adherence and allow for constant monitoring so that there can be an escalation point back to virtual or in-person care.

Remote patient monitoring to integrate the care at home is another key area and we're really thinking about building the platform that can be the plugin for all of that. A lot of our health plan clients have already made investments in digital care point solutions. The holy grail is addressing that point solution fatigue by having one infrastructure that allows for integration. 

For payers specifically, they're not interested in just having this one-stop-shop platform, but also having the ability to influence the care of their members within that ecosystem. We've taken some unique approaches to the way we can embed access points within health plan assets, whether it's their portal or the employer's portal, to make it a seamless process between enrollment and future engagement. We have things like mobile responsive design so that you're not downloading five separate apps, and it's a seamless entry point. We've invested in capabilities that allow our health plan customers to influence the point of care so that we can bring plan insights and put them in front of the virtual provider to address gaps in care, or to have awareness of where members have other care access. We're also supporting navigation within plans and provider networks to drive the cost savings that can come from steering members to higher quality and lower cost providers.

Q: Amwell powers virtual primary care services for many large insurers. Why should other health plans consider the same?

CH: There's different models of virtual primary care and we've got 55 health plan clients. For some we're powering the technology and platform behind their virtual care offering. We're seeing more and more interest here — even from mid-market Blues plans, who in my experience used to want to be Switzerland in terms of not having provider preference. But that's really changing.

There's a necessity to do this and an opportunity to partner with providers to drive the right utilization and care in the right place. They're testing it out with smaller provider groups. Part of the value proposition you're seeing with us is Amwell Medical Group, which in some cases is the primary group. Some health plans also bring in their own provider network partnerships and use AMG as a wraparound or supplemental service so that you're able to use the full spectrum of their network providers, along with ours. 

Q: Final thoughts?

CH: Payers are ambitious about impacting the Triple or Quadruple Aim — that's always a main focus. What this digital care ecosystem and platform approach promises is one of the first strong opportunities to address all of those simultaneously. It's starting with a more seamless member experience, from point of access and enrollment through the ongoing convenience and support — all the way to improving access to a mix of hybrid services and ultimately impacting clinical outcomes. 

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Featured Podcast

Top 40 articles from the past 6 months