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By Monica E. Oss

Greetings from Gettysburg, Pennsylvania, where its finally sunny and we’ve gathered 250+ executives for The 2018 OPEN MINDS Executive Leadership Retreat. The first half of the retreat has been all about developing new partnerships and new models of care in a value-based market.

Monday’s seminar, How To Build Value-Based Payer Partnerships: An OPEN MINDS Executive Seminar On Best Practices In Marketing, Negotiating, & Contracting With Health Plans, led by my colleague and OPEN MINDS Senior Associate Richard Louis, provided a roadmap to building new relationships with health plans. Yesterday’s featured speaker, William Lopez, M.D., CPE, Senior Medical Director, Behavioral Health of Cigna Behavioral Health, discussed Cigna’s key initiatives for addressing the needs of consumers with complex conditions in his presentation, Key Issues Shaping The Market For Complex Consumers: The Health Plan Perspective On What Executives Need To Know To Succeed. And this morning, we heard from Debra Smyers, Plan Product President of Centene’s Sunshine Health about their plans for improving access to behavioral health services by moving to new value-based models in her session, Next Generation Models For Health Plan Behavioral Health Services. A common theme in all three presentations was the importance of improving both consumer access to services and consumer engagement in their health care—and several times throughout those discussions, telehealth was mentioned as one of the preferred solutions to addressing those issues.

One aspect of the discussion really got me thinking. In Dr. Lopez’ session, when asked by the audience about “telehealth”, he used the term “virtual health.” What I have been mulling over the past two days is that what we have traditionally referred to as “telemedicine” is now part of a much broader category of tech-enabled therapy services. All three presenters referred to “virtual health” services ranging from virtual online provider networks; asynchronous “store-and-forward” diagnostic services; and automated programs like eCBT and mindfulness apps.

This raised a critical market question in my mind: Are health plans at the point where they will accept this range of services as functionally equivalent to face-to-face services? If outcomes and consumer satisfaction are the same, are any of these service solutions acceptable? If the answers to those questions are “yes,” the door is open for the complete disruption of traditional “therapy” services market.

The widespread move to value-based reimbursement and a greater acceptance of the “virtual health” concept will rapidly increase the market for automated therapies driven by augmented intelligence. The rationale isn’t complicated—therapies using these tools are both extremely convenient for consumers and a fraction of the cost of “real time” therapies delivered by a clinical professional.

And while consumer preference may still be an issue, that won’t always be the case. We recently wrote about a new survey showing that about 18% of consumers use telehealth services (see Telehealth Gains Popularity, Telehealth Budgets Don’t), with many consumers reporting concerns around privacy and insurance coverage. But while the majority of consumers prefer face-to-face therapy today, those preferences will likely change with time as the generation that is more comfortable with online communication ages.

For provider organization executives, success in the therapy market will require integration of tech-enabled services into their service lines. One big issue will be identifying those conditions or situations where on-site face-to-face service delivery is clinically superior to tech-enabled therapy models. This is a question without an answer right now (I think), but a question that will ultimately determine the “right size” of the supply of clinical professionals in the U.S.

The other big issue will be understanding consumer preferences. Executive teams will need a better understanding of how consumers select therapy services. As we recently reported on, that selection criteria isn’t necessarily driven by clinical outcomes (see How Do Consumers Pick A Provider? It’s Often Not Quality).

It appears that best practices in the delivery of a wide range of therapy services (counseling, assessments, case management, remote monitoring, and more) is being reinvented as we speak. Staying ahead of the curve in the change of preferred clinical service models is one of many challenges faced by specialist organizations serving complex consumers. For more on this topic, check out these resources in the OPEN MINDS Industry Library:

  1. Beacon Health Options Adds MDLIVE Behavioral Health Professionals To Its Provider Network
  2. How To Create A Telebehavioral Health Strategy – Executive Web Briefing Sponsored By InSight Telepsychiatry
  3. Making Telehealth Work-Reimbursement & Great Execution Required
  4. ECHO Autism Teleconsultation Program Reduced Wait Times Up To Six Months For Highest-Risk, Rural Children
  5. A Traditional Market Remade-New Investments & New Competition In Behavioral Health
  6. CVS, Teladoc Team Up To Bring Telehealth To MinuteClinics
  7. Utah To Launch Pilot Telehealth Mental Health Services
  8. Anthem Teams Up With Samsung, American Well For Telehealth Program
  9. Saykara Raises $5 Million Funding Round For Pioneering AI-Powered Voice Assistant For Clinical Professionals
  10. Advocate Aurora Health & Foxconn Partner On Employer-Focused Health Technology

And join my colleague Joseph Naughton-Travers, Senior Associate, OPEN MINDS on October 24 at The 2018 OPEN MINDS Technology & Informatics Institute for his seminar, “How To Make The Right Tech Investments For Your Organization: An OPEN MINDS Executive Seminar To Technology Budgeting & Planning.”

For more live coverage this week from The 2018 OPEN MINDS Executive Leadership Retreat, follow us on Twitter @openmindscircle — and join the discussion with this year’s official hashtag: #OMLeadership.

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