Visana Health, a virtual women’s health care provider, has redesigned its annual visit to be more comprehensive and personalized.
Visana’s Complete Women’s Health Visit combines preventive care, symptom assessment, gynecology, primary care, and endocrinology expertise to provide personalized care for each patient. Telemedicine visits are 45 minutes long and include assessments of hormonal, metabolic, cardiovascular, reproductive, sexual and emotional health, as well as pap smears and mammograms.
“This is really a personalized visit, optimized for that person’s risks and questions,” Dr. Barbara Levy, Visana’s chief medical officer, told Fierce Healthcare.
Under the Affordable Care Act, most women are entitled to a fully covered annual health exam with no copays or deductibles. But today, even with these visits, women often don’t get complete answers to their symptoms or surprising claims, Levy explained. Decades ago, primary care physicians performed pap smears and pelvic exams. Over time, these become relegated to obstetrics and gynecology specialties, become siloed, and are seen less holistically. Currently, preventive visits are rushed and far from comprehensive.
“Healthcare providers are running out of time to the point where they can’t really address all of the life course issues that happen to people at certain points in their lives,” Levy said.
While there is a time and place to charge for additional tests and procedures, it is not uncommon for women to be asked to come back for another appointment, even if they are dealing with symptoms related to women’s health such as menopause symptoms such as hot flashes. This means that you will have to pay a copayment for a re-examination. Levy argues that preventive visits should always have included age-appropriate counseling. However, today’s medical professionals are ill-equipped to treat menopause.
“This is in some ways a misunderstanding of what a preventive visit should be. No one says don’t talk about problems in a preventive visit. But if a more serious issue comes up as a visit and you address it, that can be coded separately,” Levy noted.
As part of your annual visit, your Visana clinician may recommend advanced labs such as a comprehensive thyroid exam, cardiometabolic panel, lipid panel, vitamin D, and baseline insulin. These may not be fully covered by a patient’s insurance, but Visana aims to make that clear so patients don’t end up with unexpected medical bills.
In a survey of U.S. consumers earlier this year, Visana found that 62% of non-Visana patients turned to Google for health questions that weren’t answered by their healthcare provider, making it the company’s fifth report using ChatGPT. It also found that one-third of non-Visana patients received unexpected medical bills after raising health concerns after their annual visit. This also had a demotivating effect, with one in six patients avoiding discussing certain symptoms for fear of being charged extra.
In the first rollout of the new annual visit, Visana found that 87% of patients said all or most of their concerns were resolved. Visana coordinates with outside providers as needed to avoid repeat testing and refer you to in-person care.
Levy believes it’s not just a provider education issue, but also a payment issue. A fee-for-service system does not encourage providers to provide extended visits or to see patients comprehensively. A typical problem is that patients end up seeing many different specialists, but no one can talk to each other.
“Then all of a sudden you’re given 14 drugs, and you get all the side effects of those 14 drugs, and you don’t actually get to the root cause,” Dr. Levy says. “Can we as a society decide to care for health rather than care for disease in an evidence-based way?”
Many of Visana’s payer agreements include value-based elements, such as care coordination fees and shared savings arrangements. Visana claims to reduce employers’ healthcare costs by 34% and unnecessary procedures by 78%, delivering savings of more than $2,400 per enrollee per year.
