The widespread adoption of telehealth is what UnitedHealth Group CMO Margaret-Mary Wilson, MD, calls "one of the most dramatic changes" in healthcare, but the next step is using that development to drive health equity.
In a roundtable on using telehealth to address health inequities, three UnitedHealth Group leaders — Dr. Wilson, Optum Care CMO Daniel Frank, MD, and Catherine Anderson, senior vice president of strategy for UnitedHealthcare community and state — outlined how the pandemic formed virtual medicine, ways UnitedHealth Group is using it to support underserved communities and what questions still linger as telehealth moves forward.
Eight takeaways:
1. Dr. Wilson said from a clinical standpoint, UnitedHealth Group is viewing telehealth as a means of connecting a patient to a healthcare team. But from a health equity standpoint, she said it becomes a "gateway" for bringing underserved communities into integrated care models and addressing whole person health.
2. The payer is looking to strike a balance between relying on virtual care to improve access and leveraging in-person care to fill in telehealth's blindspots.
3. NavigateNOW, UnitedHealthcare's virtual-first health plan, is still drawing data on where telehealth is most amenable to patient care. Based on early data, diabetes management as well as mental and behavioral health all shine as strong contenders for virtual-heavy approaches.
4. Dr. Frank said about a third of patients have unmet social needs, including limited access to the internet or technology. This lack of access can be a double bind on top of other social needs.
5. To expand telehealth access, UnitedHealth Group is providing some members with pre-data-loaded devices — many of which are equipped to accommodate vision, sensitivity and lapses in digital literacy. The company is also working on looping data from wearable technology and sensors into the tools that care management teals have access to.
6. Primary care will continue to play a foundational role in addressing health inequity, Dr. Frank said, because it begins a "longitudinal relationship" between care teams and patients.
7. Ms. Anderson highlighted the role telehealth plans play in reaching the 40 percent of Americans who live in areas where behavioral health providers are few and far between. This issue snowballs, as individuals who live in these areas also are likely to struggle with access to in-person care.
8. Only 34 percent of Medicaid claims involve telehealth, Ms. Anderson said, which is low compared to Medicare (44 percent) and commercial (60 percent) members. As Medicaid membership continues to grow, continuing to expand telehealth utilization among Medicaid beneficiaries during and after the pandemic is crucial, she said.