The Key to Patient Satisfaction With Payers? The RIGHT Telemedicine Solution

Health insurance companies don’t have it easy. Amazon, Lyft, Netflix and the like have trained consumers to expect to control all aspects of their lives from their phones. In this world of convenience and empowerment, the health care system seems antiquated and designed for maximum user frustration. And health plans seem to bear the brunt of patients’ ire.

A recently released J.D. Power 2019 Commercial Member Health Plan Study reports that satisfaction among nearly 29,000 commercial members of 146 health plans across the U.S. breaks down once members start looking to their health plans for guidance in areas like navigating issues related to cost or when to use primary care versus urgent care.

Modern Medicine with Antiquated Access

As Healthcare Finance reports, “many plans miss the mark on customer expectations.

“Health plans are doing a good job managing the operational aspects of their businesses, but they are having a harder time addressing the expectations members have based on their experiences in other industries where their service needs are more effectively addressed with better technology.”

Take, for instance, the first point of access for a patient who simply wants to know if something’s wrong and what they should - or shouldn’t - do about it. It could be a series of phone calls or a few days’ worth of appointment times, but it’s almost never a quick - and free - solution. Legacy healthcare is stuck in the 1970s, behind phone trees and appointment wait times. What’s worse is that inefficiencies seem to be hardwired into the system. Patients wait days or weeks with their newly-discovered problems, often seeking guidance from urgent care and advice lines ahead of meeting with a doctor who can understand their situation and help form a plan of care.

Then, there is the billing quagmire. Health insurance companies, which take on financial responsibility for meeting health care needs and affording patients accessible and quality care, can find themselves in a largely antagonistic relationship with the local health systems and medical practices with whom they are supposed to partner. Add in billing and health information regulations, and navigation and timeliness get even more confusing.

Virtual Care That Exceeds Consumer Expectations

But is all lost for payers? We don’t think so. Some health insurance companies are breaking legacy care access barriers by getting directly involved in patients’ care journey. By providing instant, free online access to dedicated physicians and clinical resources, payers are finding they can now own provider access simply by hosting a better customer experience. Tech-enabled solutions such as asynchronous, virtual care conversations go beyond traditional fee-for-service telemedicine and allow payers to own instant provider access and put better access and navigation into member’s hands, increasing satisfaction and lowering costs.

In this next-gen virtual care model, payers are empowered to offer up access and guidance to their patients, giving patients the control they want and the convenience they expect.

Do I call my doctor? Is the ER the right place to be? Do I even need to be seen for this at all? Could the right physician, with agency to assess my situation, actually call in a prescription if needed and efficiently and effectively improve my journey? With virtual care support that’s focused on navigation, human support and value-based care delivery, these questions can be answered quickly, conveniently, and securely - and often without the price tag associated with other legacy solutions.

Programs such as MyCareAlaska from Premera Blue Cross Blue Shield and AnytimeMD from Aetna are programs that empower health plan members with a new first step option in their health care journey. Board-certified, multi-state licensed physicians staff services that allow members to get answers to questions without the frustration, delay and out-of-pocket cost of usual services such as advice lines, minute clinics, walking in urgent care or traditional fee-for-visit telemedicine.

What We’ve Found

At CirrusMD, we have found that 83% of patient issues handled on platforms we power are resolved when a patient simply interacts with a physician via text with no copay (with the exception of high-deductible health plans which are required by law to charge one). No wait time, no exposure to illnesses in a waiting room, no loss of time from work for what might be a simple-to-resolve problem.

The fact that quality care isn’t as accessible and convenient as a rideshare or a pizza doesn’t speak to the complexity of medicine, it speaks to the antiquated nature of the healthcare experience.

And just as someone figured out how to turn shopping into an experience you can do anywhere, anytime, someone is going to solve for a better member experience when it comes to the health system journey. In fact, someone already is.

Health insurance companies don’t have it easy, but those that take the lead in streamlining member experience toward a more satisfying, higher value one will find themselves topping member satisfaction surveys. They will be seen as the stakeholders that fixed a broken system, not the ones to blame for keeping it broken.


Blake McKinney

Blake McKinney, MD is the Co-Founder and Chief Medical Officer of CirrusMD. As an emergency physician in Northern California, Dr. McKinney brings a unique perspective to CirrusMD and how our clients can best utilize the platform. Dr. McKinney completed his internship and residency at UC Davis Medical Center after graduating from the University of Texas Medical School. Prior to medical school, he served for four years in the US Marine Corps. He received his bachelor's in Biomedical Science from Texas A&M.