In today’s rapidly changing healthcare environment, payers look for new ways to add value for their clients and members. The value they seek comes from improvements to supply chain, improved access, strengthened member experience, and ultimately, reduced total cost of care.
One way to solve these challenges is by integrating primary care into their health plans. This approach can also yield dividends in situations where agility and quick pivots are needed to meet the needs of members, like the current COVID-19 pandemic. Let’s take a closer look.
How Advanced Primary Care helps payers
An integrated primary care offering, like Vera’s Advanced Primary Care (APC) model, solves many of the challenges that payers face today. It improves access to care which increases member satisfaction. It also enables payers to design care delivery that aligns with the payer’s goals for its population and the populations’ needs.
APC also delivers higher quality care and improved health outcomes. These improved outcomes, coupled with a reduction in waste, drive down costs. 80-90% of care is delivered from dedicated care centers that are easily accessible to members — whether that be talking by phone or video or bringing someone in who has an urgent need. This eliminates the need for unnecessary specialty care, allowing for both lower costs and a better member experience.
How does integrated primary care increase a payer’s agility in times of crisis like COVID-19?
In times of crisis, agility is key. We’ve all learned this as we’ve shifted the way we do business to respond to COVID-19. An integrated primary care offering like APC gives payers greater influence on the entire care delivery system. This alignment means that the entire system can pivot quickly to meet emergent needs without negotiating with stakeholders with differing goals. In a crisis, quick decisions must be followed by quick action. An integrated primary care offering makes that possible.
What’s different about the Vera APC model?
Vera Whole Health CEO Ryan Schmid puts it this way:
“It comes down to two things: empathy and outcomes. The entire culture of Vera is wrapped around this idea of empathy. It means helping people change behaviors by engaging them through empathetic listening. There’s a lot of research that links experience of empathy with improved outcomes. When we’re able to demonstrate the two together, it makes for a very compelling offering.”
How do primary care centers deliver on the outcomes, and how does that benefit payers?
The Vera system focuses on driving specific outcomes for that population. When we implement a network of care centers for a payer, we leverage an informatics platform that identifies health risk opportunities from claims data and provides actionable insight into utilization. These insights inform implementation of a care model that meets the specific needs of the population.
The combination of insights from data, increased accessibility, and our focus on behavior change empowers our primary care providers. They proactively care for members and focus on treating issues before they become major so that members only access specialty care when needed. This in turn drives down total cost.
Can Vera scale to quickly meet growth needs?
Vera has the operational capacity to scale up care centers quickly. And, as Ryan Schmid recently reflected: “We've built very specific scale ratios to take us well beyond that, should the need arise. And they're tremendous economies of scale in specific geography. This is a huge advantage that Vera brings to payers.”
Payers looking to improve their market share, attract and retain members, and lower costs should consider integrating the Vera APC model.