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What is a virtual-first health plan? Your questions, answered.

A woman on the couch, in the middle of a call with a doctor on her phone

By Elizabeth Joyce

As the healthcare landscape continues to embrace innovation, virtual-first health plans (VFHP) have emerged as a way to deliver care that is convenient, accessible, and member-centric.  

So, what does that mean for payers and what should they consider as they build their VFHP strategies? Read on to find out as we answer some of the most frequently asked questions about VFHPs.  

What exactly is a virtual-first health plan?

VFHPs integrate virtual and digital care into a comprehensive health plan and apply advocacy and incentives to encourage members to use these services as their primary means of care. This reduces the need for in-person visits and instances of costly readmissions. 

How do they work?

VFHPs operate by hosting all virtual care and digital point solutions on a single platform with one digital front door, creating a seamless member experience. A successful VFHP should: 

  • Have a single entry point that leverages your brand.  
  • Use virtual primary care as the mainstay of the experience to create longitudinal relationships between members and in-network providers. 
  • Refer to other virtual and digital health programs by giving your provider groups the tools they need to easily make referrals from virtual primary care or urgent care visits. 
  • Extend care beyond the visit using digital companions that engage members before, between, and after care to support condition-specific needs, uncover and identify potential issues sooner, and escalate care to avoid more costly emergencies. 

What are the benefits?

Improved access to care

This is one of the biggest benefits of a VFHP. By removing barriers and making healthcare more accessible, especially for members in remote or underserved areas, they can create longitudinal relationships with their providers, and foster connections that result in improved engagement. 

Cost savings

VFHPs offer significant cost savings, resulting in lower premiums and out-of-pocket expenses. These plans do this by reducing expensive and avoidable hospital readmissions, improving population health outcomes, minimizing the need for physical infrastructure, and streamlining administrative processes. 

Improved member outcomes

VFHPs can help prevent costly acute care episodes down the line. The emphasis on preventive and longitudinal care can lead to better health outcomes for members, reducing the need for more invasive and costly procedures.  

And it’s not just that – remote monitoring and regular check-ins allow for continual management of chronic conditions, leading to better health outcomes and reduced hospitalizations. 

What does the future hold for VFHPs?

These health plans are a significant shift in the way healthcare is delivered. The future of VFHPs is promising, with ongoing advancements in technology and increasing acceptance among patients and providers. Thoughtful integration of advancements into virtual care platforms will enable more personalized, predictive, and informed healthcare, improving member outcomes and streamlining care delivery. 

Ready to dive deeper into the world of VFHPs? To learn more about how a virtual-first health plan strategy can support your organization, read our eBook.