Oscar Health bets on virtual primary care

The coronavirus pandemic has driven interest in telehealth among patients and physicians like never before. Oscar Health is betting that the appetite for virtual care is here to stay.

The New York-based health insurance startup said Thursday that it will offer individual and family plan members in certain states a new option to receive all primary care services virtually, beginning in 2021.

Just like at a brick-and-mortar primary care practice, members who choose the option will see the same care team during each virtual visit. Each primary care visit, as well as generic and low-cost brand name prescription drugs, labs, and diagnostic imaging orders and the first specialist visits will cost the member nothing out of pocket. The option will be offered on all of Oscar’s health plans in areas of California, Florida, New York and Texas.

“The idea is that members will develop long-term relationships with clinicians that get to know them and understand them and meet them where they are within their healthcare journey and quite literally where they are in their life, which is part of what makes the virtual model so appealing and attractive to so many of us even before the pandemic, but especially now in this context where people are seeking safer more convenient alternatives to care,” said Meghan Joyce, Oscar chief operating officer.

Separately, Oscar also announced an expansion that will bring its health plans to 19 states and 47 markets, including four new states and 19 new markets next year. The new states include Arkansas, Iowa, Oklahoma and North Carolina.

Oscar previously provided all members no-cost telemedicine visits for urgent care. Building out a virtual primary care program was in the works before the COVID-19 pandemic took shape, but the crisis brought a new urgency to launching the option, Joyce said.

Oscar said visits with its virtual urgent care team has doubled since the pandemic began, compared with the same period last year. About 60% of Oscar’s behavioral healthcare visits and 50% of visits related to diabetes, hypertension, hypothyroidism and gastro-esophageal disorders were virtual in April, according to a company spokeswoman.

“We’ve seen a major shift both in our network and also with members seeking care in our virtual practice,” Joyce said. “We’ve seen a shift from care that would have ordinarily taken place in person toward virtual, and we are seeing an outsized interest in preventative and proactive care such as refilling prescriptions, (durable medical equipment) refills—people seeking care to get out ahead of their care needs understanding that the healthcare system might be strained in a time of COVID.”

The virtual primary care option will leverage the same physician practice—Oscar Medical Group—that handles urgent care visits. Oscar said it has a capitated agreement with the medical group, which is independent from the insurance company but provides services exclusively to Oscar health plan members.

Some members who choose virtual primary care will have access to in-home blood draws, home monitoring kits and in-person follow up care at no out-of-pocket cost when ordered by an Oscar primary care provider. The first specialist visit when referred by a provider will also be no cost.

Oscar’s new program echoes a pilot launched by Humana last year. The Louisville, Ky.-based insurer partnered with virtual care platform Doctor on Demand to offer small businesses in Florida and Texas a virtual primary care health plan, in which members would see one doctor and have no copayments. Humana said the premiums for the plan would be half as much as the company’s most popular purchased plan. In Oscar’s case, virtual primary care is not a separate health plan, however, but an add-on to existing health plans.


Source: modernhealthcare.com

Tags: covid-19, pandemic

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