Moving from Hype to True Hybrid: The Key to an Integrated, Health-Focused Care Experience

By Nate Murray

Over the last few years, demand for virtual services has exploded and many new virtual care entrants have flooded the space, particularly to meet episodic urgent care and mental health needs. On the provider side, brick-and-mortar clinicians sprang into action to offer video visits, but many struggled to coordinate care and manage high-quality referrals across settings. The telehealth industry, growing rapidly to meet market demands, has felt some growing pains, largely rooted in the siloed, incongruent nature of virtual used predominantly for reactive care.

While it’s safe to say that the benefits of virtual care—including improved access, efficiency, and flexibility of care—are widely accepted and appreciated by providers and consumers alike, there is still much room for improvement in integrating those episodes of care into part of a larger, collaborative care model. Virtual care reaches its full potential when it goes a step further to consider patient health goals and outcomes, with a proactive, team-based approach focused on holistic care, and is particularly effective when this care is provided in an integrated, hybrid model. 

Optimally, high quality primary care, mental care, physical medicine, health coaching, and even care navigation are integrated in a comprehensive care offering—whether operating virtually, in-person, or in some combination. Said another way, patients’ benefits and costs are reduced when a biopsychosocial framework that includes proactively closing care gaps, coordinating care across settings, and being accountable for the outcomes achieved is embedded within a hybrid care model. With this framework, providers can meet patients where they are and empower them with choice. 

Choice Fosters Trust

In the HR Research Institute’s Virtual and Hybrid Care Pulse Survey 2023 of human resource decision-makers, 70% of respondents said they were worried that a virtual-only care offering could frustrate their employees who want in-person treatment, and 57% were concerned it would limit employees’ access to certain types of care. The survey also found that 73% of employers agreed it’s important for employees to be able to seamlessly move from in-person to virtual care.

We all do this naturally in our day-to-day interactions with family, friends, and colleagues. Think about how you move seamlessly between text messages to phone calls to sharing meals together. Whether we’re shopping or banking, we navigate functions in a way that fits our lifestyles—online, in person, or some combination of service delivery. Throughout life, different channels and spaces help us maintain vital connections—and healthcare should be no different.

Hybrid care is not defined merely by a virtual presence, but by a variety of engagement opportunities to maintain consistency and continuity of wellness. When this fails to be maintained, open loops, dropped exams, and missed appointments are the result. Unfortunately, our current healthcare model demonstrates that no one clinician is invested in managing referrals or follow-ups, and patient outcomes suffer. Alternatively, continuous care models breed engagement from both the patient and care team for a genuine investment in wellbeing.

For context, our hybrid-focused model was not “invented” in response to the pandemic: Over the past decade plus, we’ve been evaluating member engagement and adoption, learning about preferences. Some members want to engage in-person for the preliminary 60-minute primary care appointment, then engage in follow up virtually. Others rely heavily on back-and-forth asynchronous messaging, a tool that facilitates efficient communication outside the office setting. For preventive measures, Crossover achieved a 14% higher care gap closure rate among members accessing hybrid care vs. members accessing only virtual care. The key here is patient willingness to engage if provided the right tools and support. 

An Integrated Care Model

In a recent NewsBreak post, contributor Adam Tabriz, MD, examined patient engagement and practice workflow models of hybrid care, noting that “ensuring continuity of care… into cyberspace requires integrating in-person medical facility encounters with [the] virtual care modality.” He refers to a report published by the Integrated Care Journal that noted the failings of virtual care for some patients, including “missing links,” summarizing that “the virtual healthcare system lacks a hybrid state of patient care and work model.” Part of successful virtual care implementation requires parallel workflows executed in tandem with in-person episodes, Dr. Tabriz asserts, not the “mismatches” that are common in today’s siloed delivery approaches. 

Dr. Tabriz nails it. We hear this same feedback from employers and brokers. Indeed, when healthcare is offered through separate providers and delivery methods, the model fails to foster longitudinal relationships that engage members and improve wellbeing. It’s episodic, fragmented, and simply falls short. Taking it a step further, the health of entire populations is adversely impacted by disjointed, reactive sick-care solutions that fail to connect and therefore fail to effectively address acute flare-ups of back pain, relapses of depression, or recurrences of dermatitis, for example, to the longitudinal health of the member. Instead, by maintaining a continuous care model across settings, oriented toward achieving optimal wellbeing, providers can achieve optimal engagement, satisfaction, and outcomes over the long term. In meeting members’ current and comprehensive needs, we progress beyond the hype of hybrid toward a meaningful, integrated approach to care. Employers and health plans should consider how to help architect this type of access simply through new plan designs that make it easy to access the foundational primary care team in person or virtually.  

Nate Murray is a founder of Crossover Health and the Chief Revenue Officer. He is an entrepreneur with a strong passion for healthcare and more than 20 years’ experience in the industry. He helps develop shared savings programs that deliver objective improvements along the cost, quality, and experience dimensions.

Be sure to look for Crossover Health, co-sponsor of the ATA2023 Welcome Reception!