Telehealth utilization rose dramatically during the COVID-19 pandemic, including among populations who have traditionally faced barriers to healthcare access. During this period, the Centers for Medicare and Medicaid Services (CMS) authorized states to expand Medicaid coverage for virtual healthcare services, which has improved both access to and utilization of care.
Patients are less likely to be no-shows for telehealth visits, and telehealth improves providers' ability to "engage individuals who were historically difficult to reach in services."
This makes telehealth a valuable tool for reaching traditionally underserved populations and improving patient engagement for better health outcomes.
Defining Virtual Healthcare and Its Core Components
Telehealth is an umbrella term that refers to systems of electronic and telecommunications technologies that enable the remote delivery of health and medical services. Telehealth can include a variety of services, including:
- Telemedicine: Clinical care provided via interactive video and/or audio communications
- Remote patient monitoring: Medical devices that electronically transmit patient data to providers, such as cardiac monitors, glucose monitors, or consumer-grade wearable devices like smartwatches
- Data-sharing platforms: Patient portals that allow patients to access their electronic health records, communicate with providers, and schedule appointments
Telemedicine can provide a variety of services, including:
- Urgent care
- Primary care
- Behavioral health
- Specialty care
While telemedicine is an excellent tool for many types of primary and preventive care, some conditions cannot be treated with telemedicine. Any health situation or condition that requires physical therapy, lab work, or medical imaging will need in-person treatment. In addition, surgery, wound care, and burn care cannot be delivered through virtual care, nor can some types of specialty healthcare, such as ophthalmology and dental care.
Addressing the Unique Needs of Medicaid Populations
Health disparities persist as a significant issue across the United States. People of color, people with low incomes, and people in rural areas are less able to access the care they need. That lack of access leads to poor health outcomes compared to individuals with better access to care.
Telehealth can help patients overcome barriers to accessing care. Patients don't need to arrange transportation for virtual medical appointments, for instance. An individual who might shy away from taking half a day off from work to travel to and from a doctor's office may be more amenable to scheduling a short virtual visit during a planned break. Patients in rural areas can see providers who are geographically distant and would be inconvenient to see in person.
Medicaid plans and virtual care coverage vary by state. Some states have robust coverage options that give patients access to a large network of providers. Some state Medicaid rules even allow patients to see providers from outside the state.
The Behavior-First Approach: A New Paradigm in Virtual Care
Telehealth options can be tailored to the needs of specific patient populations. In addition to virtual appointments, services like text or email alerts from medical offices, personalized health reminders, and online educational materials can all help patients make positive behavioral changes in support of their health.
Principles of Behavior-First Models in Healthcare
Behavior-first principles can support patients as they take an active role in their own health. This approach goes beyond giving them detailed instructions; it also gives them the tools to take the actions needed for lasting, positive changes:
- Patient-centered design: Healthcare delivery systems should serve patients' needs. This may include logistical changes such as offering extended hours or weekend appointments and increasing access via telehealth tools.
- Behavioral economics: Rewarding desired behaviors in the healthcare space can include gamified apps that reward users with badges, visible progress tracking, and material rewards such as gift cards or merchandise credits.
- Habit formation: Creating a new habit can be challenging. Tools that offer reminders and positive reinforcement during the early stages of habit formation can build consistent behaviors to improve someone's health.
- Personalization: Programs and tools should be personalized to the patient, their circumstances, and the desired behaviors.
- Continuous feedback loops: Reinforcement loops may include an in-app reward badge delivered along with a reminder to repeat the action the following day and a promise of another reward at that time.
How Behavioral Interventions Enhance Patient Interactions and Outcomes
The future of virtual healthcare will be shaped by programs that follow principles of behavioral science in healthcare delivery. These systems can help patients make lasting, positive changes. Virtual healthcare platforms can provide motivational support and a sense of empowerment.
This technology can result in improved outcomes, including:
- Increased treatment plan adherence
- Reduced risk of skipped appointments
- Improved chronic disease management
Medication Adherence: A Critical Challenge in Medicaid
Bolstering adherence to treatment plans is key to improving outcomes for Medicaid patients. Only about 50% of patients with chronic conditions take their medications as prescribed. Social determinants of health, such as socioeconomic barriers, multiple diagnoses, and inadequate health education, can result in low adherence rates. Virtual healthcare platforms that employ features like notifications and rewards systems can improve adherence rates, resulting in better overall outcomes.
Measuring Success: Outcomes of Behavior-First Virtual Care Models
Behavior-first virtual care tools offer a wealth of trackable data. Key performance indicators (KPIs) include:
- Medication adherence rates: Percentage of patients taking prescriptions as directed
- Patient interaction metrics: Log-ins, completed tasks, session lengths, or responses to prompts
- Appointment attendance: Virtual visit completion rate and no-show reduction
- Patient satisfaction scores (e.g., NPS, CSAT): Feedback on ease of access, relevance, and support
- Health outcomes: A1C levels, blood pressure, BMI, or condition-specific improvements
- Cost savings: Reduced ER visits, hospitalizations, and avoidable readmissions
- Time to intervention: Average time between patient-reported issue and provider action
Leveraging Technology to Improve Adherence: Wellth's Behavioral Science Platform in Action
Wellth is a daily care motivation platform that uses behavioral economics to encourage actions that lead to better health outcomes and a reduced cost of care. The mobile app gives users daily reminders to complete essential health tasks, such as taking their medications or checking their blood glucose levels.
Members upload photos directly into the Wellth app, and the app verifies adherence, unlocking health incentives that really work. The Wellth incentive system provides meaningful rewards for healthy behaviors, helping members afford essentials like groceries, clothing, and transportation.
The Wellth platform is proven to engage hard-to-reach populations, increase patient acquisition, improve care adherence, and generate better health outcomes for members. Wellth users see an average 29% reduction in emergency room utilization, a 42% average reduction in inpatient admissions, and a 100% to 300% ROI on cost-of-care reduction.
Contact our team today to learn more about how Wellth can improve health outcomes for Medicaid populations.
