Geriatric EM Virtual Specialty Care: Providers and Payors Unite

Virtual Specialty Care: Providers and Payors Unite!

By Mary Mulcare, MD, on behalf of the SAEM Academy of Geriatric Emergency Medicine

One year ago I wrote a segment for this publication on the transformation of the digital care landscape, which focused on older adults. The virtual provision of medical care supports faster access to high quality physicians, while alleviating the traditional barriers to care, including transportation, available caregiver support, sensory concerns (e.g., difficulty hearing in loud environments), and more. In both academia and industry, virtual care has contributed to significant innovation and improved the health care landscape and experience for patients and providers. I am happy to report that older adults have been benefactors of these advancements and are becoming a greater focus as recipients of virtual care. Patients and providers have accepted and adopted virtual care. For many providers, the opportunity to conduct virtual visits provides balance and new perspectives in patient interactions. For patients, they have come to expect a virtual option. Knowing this

“In both academia and industry, virtual care has contributed to significant innovation and improved the health care landscape and experience for patients and providers.” patient expectation, employers are implementing telehealth into their health benefits packages as a necessary offering for employee satisfaction and retention. Payors are next to see the value of virtual health, especially virtual specialty

care, where payors and providers are primed to collaborate. Medicare Advantage plans, for example, work hard to retain their members. Each year an average of 9% of Medicare Advantage members disenroll from their plan, with some plans reaching as high as 23% disenrollment. The top reason for disenrollment is lack of coverage with doctors and hospitals. Up to 27% of Medicare beneficiaries have trouble finding a specialist. Once they find a specialist, wait times for an appointment are several weeks and those appointments on average last between 15-20 minutes.

Virtual specialty care is a likely, cost-effective solution for Medicare Advantage plans. This type of care brings convenience, speed, and quality to the process of identifying and connecting with appropriate specialists, all while allowing older adults to see the physician from the comfort of their home. These visits can last upwards of one hour, so members can get answers to all their questions.

For Medicare Advantage plans, virtual specialty care has the potential to: • Reduce unnecessary emergency department visits and roaming in the health care system • Provide an alternate high-convenience option for emergency department discharge follow-up visits • Reduce hospital admission rates • Give geriatric and primary care colleagues the support needed to maintain their role as the medical home for their patients while ensuring adequate guidance, when needed • Increase medication adherence while reducing polypharmacy and adverse drug events

This list goes on, but the fact of the matter is that older adults have much to gain from Medicare Advantage plans that offer virtual specialty care.

ABOUT THE AUTHOR

Dr. Mulcare is fellowship trained in geriatric emergency medicine and is a clinical assistant professor of emergency medicine at NewYork-Presbyterian/ Weill Cornell Medicine. She has held several educational leadership roles at NYP/Weill Cornell and is currently chief medical officer for Summus, a leading virtual specialty care platform. She is a member-at-large on the executive committee of SAEM’s Academy of Geriatric Emergency Medicine (AGEM).

About AGEM

The Academy of Geriatric Emergency Medicine (AGEM) works to improve the clinical care of older patients, prepare trainees to care for older patients, and advance the geriatric EM research agenda. Joining AGEM is free! Just log into your member profile. Click “My Account” in the upper right navigation bar. Click the “Update (+/-) Academies and Interest Groups” button on the left side. Select the box next to the academy you wish to join. Click “save.”