Private Payers News

UnitedHealth Group Kicks Off Integrated Virtual-First Health Plan

The new virtual-first health plan will be available in nine cities and will aim to integrate virtual and in-person care needs.

primary care services, virtual care, virtual-first health plan, UnitedHealth Group

Source: Getty Images

By Kelsey Waddill

- UnitedHealth Group has launched a virtual-first health plan with the goal of integrating in-person and virtual care.

“By collaborating with Optum, UnitedHealthcare is developing a more integrated and coordinated health care system that uses technology and personal support to help encourage whole-person health, which may help prevent and detect disease before it starts,” said Rhonda Randall, DO, executive vice president and chief medical officer at UnitedHealthcare for employer and individual.

Once an individual enrolls in the NavigateNOW virtual-first health plan, the new member must fill out a profile that will inform the member’s care team about her prescriptions, conditions, and preferences. 

The care team consists of a board-certified provider and the member’s primary care provider spearheads the team. The primary care provider is prepared to deliver care both virtually and in-person. 

For virtual care needs, the member will leverage Optum’s virtual care platform and will have access to the Optum virtual care medical group. Through this same platform, the care team can coordinate care between the member and specialists across the US.

Members in UnitedHealthcare’s NavigateNOW virtual-first health plan will have on-demand access to primary care, urgent care, and behavioral healthcare services through virtual care. These services will have zero additional cost-sharing. There will be no additional cost-sharing for most generic drugs or the unlimited chat and online scheduling features.

Apart from covering medical services and prescriptions, the health plan will also incentivize wellness. UnitedHealthcare will reimburse members over $1,000 per year when they use a wearable device to track certain activities such as walking or strength training.

UnitedHealthcare projected that the new health plan’s premium would cost approximately 15 percent less than other plans that are not virtual-first health plans. 

UnitedHealthcare already offers virtual health plans, but through NavigateNOW the payer indicated that it would extend access to members in employer-sponsored health plans scattered across the US. 

Employers in nine cities will be able to offer NavigateNOW to their employees. The cities are Little Rock, Arkansas; Fort Myers, Florida; Pittsburgh, Pennsylvania; Springfield, Massachusetts; Minneapolis and St. Paul, Minnesota; Richmond, Virginia; Indianapolis, Indiana; Dallas, Texas; and Houston, Texas.

“UnitedHealthcare and Optum will continue working together to modernize our approach to health benefits and care delivery, using technology and data to help make it more convenient for our members to access various types of medical care to support their physical and mental well-being,” Randall added.

This announcement came on the heels of the payer’s third quarter earnings report and call for 2021. In the call, UnitedHealthcare tentatively shared a hopeful perspective on the company’s future in 2022. With enrollment and revenue growing and utilization returning to normal levels, the payer expected that the company’s earrings for 2022 would be strong.

In 2021, the payer has already held its ground in the Medicare Advantage market. UnitedHealthcare also altered its integrated care benefits and specialty benefits for employer-sponsored health plans, improving chronic disease management benefits and member engagement in order to bolster patient outcomes.

 As the coronavirus pandemic continues to influence trends in the payer space, many health insurers are gravitating toward virtual-first health plan. These health plans use a digital front door in order to usher members into their benefits, often employing virtual care, artificial intelligence, and telehealth tools in order to do so.

Virtual health plans often offer on-demand, accessible care. They tend to stress primary care as the unifying force behind a member’s healthcare strategy. Many virtual-first health plans, such as UnitedHealthcare’s California Doctors Plan, also incorporate concierge-style support to help members navigate their healthcare tools and solutions.