HLTH: UnitedHealthcare Launches Virtual-First Health Plan

UnitedHealthcare made headlines at HLTH by announcing the launch of NavigateNOW, a virtual-first health plan that offers an integrated approach to providing care both virtually and in-person.

  • NavigateNOW is a collaborative effort between UnitedHealth’s payor arm and its Optum subsidiary that seeks to capitalize on the industry-wide shift towards hybrid care. The virtual-first health plan is designed to provide patients with a personalized virtual care team for medical and behavioral health services with a seamless hand-off to in-person treatment if needed.
  • Availability begins later this year in nine initial markets, with a goal of expanding to large employers and over 25 markets by the end of 2022. NavigateNOW offers members no copays for common services, unlimited 24/7 physician access, and reduces plan premiums by approximately 15%. 
  • The collaboration leverages Optum’s primary care and behavioral healthcare services, with UnitedHealthcare’s national provider network available for in-person visits. The integrated care model is designed to identify health issues earlier, encourage preventive care, and deliver services in the most appropriate setting.

The Takeaway

It’s a strategic priority for UnitedHealth to take advantage of the overlap between Optum and UnitedHealthcare, and NavigateNOW is the first major launch in that initiative. NavigateNOW is UnitedHealth’s first virtual-first primary care plan, and combining Optum’s digital resources with a large clinical footprint gives the service strong value proposition within the digital health market.

B2C2B as a Digital Health Go-To-Market Strategy

In a recent editorial at MobiHealthNews, Marley Medical CEO Chris Hogg laid out the case for why business-to-consumer-to-business (B2C2B) could be the best future go-to-market strategy for virtual care.

After serving as the CCO of Propeller Health (acquired by ResMed in 2018), Hogg went on to found Marley Medical in August of this year, aiming to help people manage common chronic conditions by taking a new approach to the market.

  • Early digital health companies faced problems fitting innovative products into a lagging reimbursement framework, finding themselves misaligned with existing code descriptors. Without a standard classification, most companies began working directly with payors and employers, offering them services that they could then market to their members (B2B2C).
  • The B2B2C model allows digital health vendors to be compensated by payors in a variety of ways, usually tied to enrollment or engagement. After finalizing the contract with the payor, the vendors begin overcoming implementation challenges and marketing for new members, hurdles that often lead to slow enrollment and limited revenue.
  • Virtual care’s emergence as an effective care delivery method shifts the landscape, allowing digital health startups to classify their products as “traditional clinical services” qualifying for reimbursement. It also allows them to work with and market to individuals while unlocking the ability for payors to compensate them for providing services to their own user base (B2C2B).
  • The B2C2B model gives companies control over user acquisition while enabling their offerings to be subsidized by payors – a compelling go-to-market strategy. The need to directly acquire users causes companies to focus on specific populations and build people-centric products with tangible impacts, as opposed to ones that are easy to market to payors or employers.

The Marley Medical Strategy

In a telehealth playing field that seems to be getting more crowded every day, Marley Medical is looking to set itself apart by focusing its virtual primary care offering on specific populations with chronic disease, engaging directly with patients before working with payors as an in-network provider. With Hogg at the helm and a fresh go-to-market blueprint on its side, Marley Medical is in a good position to show how effective B2C2B can be.

Walgreens Doubles Down on Primary Care

In a move to accelerate its value-based primary care strategy, Walgreens announced that it plans to take an ownership stake in VillageMD with a $5.2b investment.

The investment gives Walgreens a 63% stake in the primary care company, making it “the first national pharmacy chain to offer full-service primary care practices with primary care physicians and pharmacists co-located at its stores all under one roof at a large scale.”

  • The partnership originated with a 2019 pilot program of five co-located primary care practices designed to more closely coordinate care between patients’ physicians and pharmacists. It has since expanded to 52 co-located primary care practices, with plans to have at least 1k “Village Medical at Walgreens” locations by 2027.
  • VillageMD offers same-day appointments with its physician-led teams that include nurses, lab techs, and behavioral health specialists. It also helps physicians transition to risk-based care models, an approach that appears to be working: full-year expected revenue is $1.3b, a sharp increase from $217m in 2017.
  • Walgreens announced a new division called Walgreens Health to house VillageMD and its other clinical services, which includes the recent purchase of a 55% stake in care-at-home company CareCentrix. Walgreens Health’s goal is to provide whole-person healthcare to the 75% of Americans who live within five miles of a Walgreens.

Industry Impact

Retail clinics are quickly becoming a popular pursuit as companies like Walgreens, Walmart, and CVS Health rush to expand their clinical footprints to cater to the growing number of consumers seeking convenient care close to home.

Walgreens stated that it plans to make consumer health a key “growth engine” through partnerships in primary care (VillageMD) and post-acute services (CareCentrix), driving more volume of in-store health products while expanding healthcare access.

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