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Claims data reveals changing patient behaviors

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Between March 2020 and now, patient behaviors have changed dramatically. Thanks to a global public health crisis, going to a healthcare provider is no longer routine; it’s become fraught with risks for both patient and provider.

As a result, telehealth usage has skyrocketed. Cigna took note of this in a survey published in March 2021. Changing patient behavior will have a significant impact on payers; read on to learn what it means for healthcare payers and plans.

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Changing patient behavior is impacting payers. Here’s what you need to know.

What Cigna’s study reveals

Cigna’s study analyzed national healthcare claims. Here are some of the biggest takeaways from this report:

  • Today, telehealth visits make up 25% of medical and behavioral healthcare in facilities that allow them, up from just 1% prior to March 2020
  • Outpatient behavioral telehealth visits rose sharply—27% when compared to pre-March 2020 levels
  • Over 60% of behavioral health patients conduct telehealth visits
  • The increased use of telehealth for behavioral healthcare stayed constant, even as telehealth for other healthcare services decreased

One of the biggest takeaways Cigna researchers noticed from the data is that behavioral healthcare has become more accessible thanks to telehealth. It’s now possible (and even advisable) to talk to a mental health professional in the comfort and safety of one’s own home, making it simpler and more convenient to work on behavioral health issues.

Changing patient behaviors

The Cigna study aligns with other research about the global public health crisis. Before March 2020, telehealth usage was low; 11% of patients used it. Had the health crisis not erupted, adoption rates most likely would have grown gradually because telehealth represents a convenient option for both patients and providers. Telehealth adoption sped up exponentially after March 2020. A month after the outbreak, 46% of American consumers used telehealth services to replace canceled healthcare visits.

Moreover, attitudes toward mental health are changing. As the Cigna study showed, the global health crisis led to a dramatic rise in healthcare claims for behavioral health services. Isolation and anxiety took their toll on patients, who turned to mental healthcare professionals for guidance. Cigna’s report revealed that 97% of people who accessed behavioral healthcare services between March to May 2020 didn’t have a prior mental healthcare claim.

The impact of changing patient behavior on healthcare

What do these trends mean for the future of healthcare? There are two main conclusions we can reach:

  • Patients want telehealth services even as we begin to recover from the health crisis
  • Specifically, patients want access to mental health services going forward

Thirty-three percent of patients say they would leave their current healthcare provider if they didn’t offer telehealth services. Additionally, over three-quarters of patients surveyed by Cigna believed more care will be delivered at home in the future than in a traditional healthcare setting.

Going forward, patients will demand telehealth services from their providers and from healthcare payers. There will be a pronounced demand for virtual mental healthcare services, too.

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What do changing patient behaviors mean for payers?

Healthcare plan members will begin to demand continued coverage for telehealth services, especially for behavioral healthcare. That means there will be pressure on insurers to pay for telehealth services.

Before the public health crisis, telehealth services were reimbursed at a low rate, if they were reimbursed at all. That situation can’t continue as we enter the recovery stage; patients won’t accept it.

How can payers adapt to changing patient behavior?

What steps can payers take to adapt to changing patient behavior?

  • Encourage providers to put the right telehealth foundations in place
  • Offer providers incentives for delivering telehealth services
  • Make it easy to communicate with providers through cloud communication technology

Encourage providers to put the right telehealth foundations in place

Although telehealth has the potential to improve the patient experience, providers risk missing an important opportunity if they don’t put the right technology in place. The right technology is a modern cloud communications platform that supports telehealth service delivery and numerous other collaboration workflows.

A telehealth communications platform incorporates messaging, video, phone (MVP), document sharing, and task assignments all within defined and focused groups and through a single application. Through these integrated capabilities, providers can connect to patients through their preferred channels and coordinate care across their aligned care teams.

Payers could encourage their network providers to increase virtual care visits by offering access to telehealth services through their own cloud-based platform. Offering technical support and training can also go a long way to a smooth implementation.

Offer providers incentives for delivering telehealth services

Will providers continue to deliver telehealth services as we embark on the road to recovery? Before March 2020, many providers didn’t have an incentive to deliver telehealth services to patients. Reimbursement was either low or non-existent, and there wasn’t a compelling reason for virtual visits.

During the public health crisis, the risk of spreading a deadly disease forced providers to close their offices and offer virtual appointments. The government changed regulations regarding reimbursements for telehealth services, making telehealth a viable option for providers. Yet, will those changes stay in place after recovery?

In addition to adequate compensation for telehealth services, payers should motivate providers with incentives for delivering telehealth services. Incentives could include financial or other kinds of rewards (in keeping with regulations).

Make it easy to communicate with providers through cloud communications technology

Payers and providers have long had an adversarial relationship; payers don’t understand the logic behind providers’ treatment plans, and providers complain that payers don’t supply adequate reimbursement. This situation could continue into the recovery, which could have a negative impact on providers’ delivery of healthcare services.

That’s why it’s critical for payers to communicate clearly and effectively with providers. A cloud communications platform with messaging, video, and phone (MVP) capabilities makes it easy to connect with providers and members to quickly resolve billing issues.

RingCentral: Supporting payers with the right cloud communications platform

RingCentral’s cloud communications platform supports healthcare payers and plans as they work with providers and members to navigate the new normal. Our platform enables communication through a variety of channels for a better payer and member experience. To see how our solution can help you, request a demo at ringcentral.com/payers.

Originally published May 03, 2021, updated Jul 25, 2024

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