New York Medicaid Insurer Hopes Virtual Care Will Boost Access
February 18, 2022
New York Medicaid Insurer Hopes Virtual Care Will Boost Access
Reprinted with AIS Health permission from Health Plan Weekly, February 11, 2022
MVP Health Care has launched a new virtual care offering for its New York Medicaid members that allows them to connect with primary care and specialty care physicians through an app made by the digital health company Galileo. Kimberly Kilby, M.D., the insurer’s vice president and medical director of health and well-being, and Christopher Del Vecchio, president and CEO of MVP Health Care, tell AIS Health that they want the new partnership to improve health equity for the insurer’s Medicaid beneficiaries.
The new partnership with Galileo is part of a multiyear effort at MVP to address an unmet need for virtual care. “Over the last 18 months, nearly 40% of MVP’s Medicaid members have not seen a primary care physician (PCP), often due to competing demands on time and resources such as transportation and language barriers,” Del Vecchio tells AIS Health, a division of MMIT, via email.
The need was clear, but the not-for-profit payer wanted to approach building a solution with insight into consumer preferences. “We no longer want to assume we know what people want. We really have engaged in a more objective way of getting insight into what needs our customers [have] and been building solutions around that,” Kilby tells AIS Health.
MVP engages in a practice it refers to as “evidence-based innovation,” in which the payer uses data to measure unmet customer needs. Through this approach, the MVP team discovered the opportunity to give customers a virtual care solution to save them time and help to determine whether in-person care is necessary.
While MVP’s offering is new in the Medicaid space, virtual primary care has become a popular option in commercial plans. “This move by MVP Health Care and Galileo resembles what’s been happening with other carriers and companies, such as CVS Health [Corp.], [Cigna Corp.-owned] MDLive and
Amwell, moving populations to a virtual primary care solution,” Thomas L. Johnson, an expert with more than 20 years of experience in the Medicaid managed care industry and former executive director of the Population Health Alliance (PHA), tells AIS Health.
The partnership with Galileo’s model connects users with a network of primary care physicians via its app. Medicaid beneficiaries are able to access on-demand care 24/7 with physicians who speak English and Spanish. MVP’s Medicaid population can choose a primary care physician through the app and chat asynchronously with their provider.
In addition to primary care, the Galileo network includes providers across multiple specialties. Primary care physicians can bring in a specialist, such as a cardiologist or neurologist, to consult on a patient’s case. “It’s so important that these types of services are really improving people’s care and able to deal with chronic and complex conditions,” Kilby says.
MVP Medicaid members are able to access the virtual care services provided by Galileo at no cost in 2022, according to Del Vecchio.
Previously, MVP’s Medicaid members needed to see an in-person primary care doctor. The new virtual offering from MVP and Galileo changes that. “At MVP, we are keenly focused on the fact that customers are looking for alternative choices and they’re migrating away, especially in this post-pandemic world, from the traditional visit-based care model because it’s not working for them,” Kilby explains.
Technology Access Is a Challenge
But connecting members of the Medicaid population to virtual care is not without barriers. Approximately one in four Medicaid beneficiaries lived without internet or limited computer access at home in 2019, according to the Kaiser Family Foundation. Medicaid members without regular, reliable internet access cannot take advantage of a virtual care offering like the one launched by MVP.
The MVP team is cognizant of the digital obstacles that stand in the way of the Medicaid population accessing virtual care. In addition to internet access, there is the question of having a reliable device to access the app and understanding how to use the technology. “We’re really looking forward to actually having some experience and then being able to build solutions around what we’re seeing as the barriers that people are having,” Kilby says.
Kilby also points to changes in the regulatory environment that could make it easier for the Medicaid population to access virtual care. For example, New York’s 1115 waiver demonstration outlines the goal of creating a digital health and telehealth infrastructure for the state. The waiver recognizes the historical challenges of connecting the Medicaid population with high-quality health care. It states, “These initiatives create synergies that reinforce and support the overarching goals of this waiver proposal and our collective ability to stabilize and better serve all of our Medicaid population, particularly those most impacted due to longstanding racial and health disparities.”
MVP’s new virtual care offering is part of the payer’s effort to address health care inequity and better serve Medicaid beneficiaries.
“By breaking down these barriers to care, MVP is working to make health care more equitable and convenient for members on their health care journey,” Del Vecchio says.
Insurers Could Back Infrastructure Efforts
Insurers can put their weight behind different initiatives to help overcome common barriers to virtual care, Jerry Vitti, founder and CEO of Healthcare Financial, Inc. (HFI), tells AIS Health via email.
“Payers can help reduce the barriers that Medicaid enrollees face in accessing virtual care by supporting initiatives that improve the communication infrastructure in both rural and urban areas,” he says. “Reliable broadband is key. Investing in programs that address social determinants of health like socioeconomic status that can affect the ability to pay for internet access will also be crucial.”
While MVP’s new virtual care offering opens the door to more options for Medicaid beneficiaries, the MVP team knows that it will not be the right fit for everyone. The payer is therefore looking at ways to use data to segment the patient population and connect with the people who will most benefit from virtual primary and specialty care.
MVP is embracing digital health solutions through this new partnership, as well as through its own app: Gia. Going forward, the payer will evaluate its virtual offerings, focusing on patient outcomes. “We have to move from adoption utilization metrics to making sure we’re on par with what the in-person providers are held to [in terms of ] standards around quality and outcomes,” Kilby tells AIS Health. “Our focus over the next year is just a continual improvement of the experience.”
Other Payers Might Follow in MVP’s Footsteps
MVP’s move to provide its Medicaid population with virtual care could herald a broader industry shift. “You’re going to see the larger Medicaid-only players move in that direction as well,” says Johnson. “I would imagine Centene [Corp.] especially will be looking to move in that direction.”
Commercial insurers with Medicaid and Medicare Advantage beneficiaries could also begin to embrace virtual primary care for these populations. “I think these insurers will eventually offer this benefit to their Medicaid members as well, especially given the particular health needs of the population. State Medicaid agencies will need to continue to demonstrate flexibility in supporting this model,” says Vitti.
While virtual health is an important tool for MVP, it is only one facet of how it connects consumers with care. The health insurer is exploring ways to optimize the entire care continuum: in the virtual space, the physical space and the transition between the two.
“Ultimately, this innovative partnership creates greater access to care for our Medicaid members. This option uniquely positions MVP and Galileo to better address the unmet needs of our Medicaid population,” Del Vecchio says. “We are proud to be the first health insurer in New York to offer this innovative option.”
by Carrie Pallardy