A look at Blue Shield of California's Virtual Blue plan

April 12, 2024

A year ago, Blue Shield of California joined forces with Accolade and TeleMed2U to launch Virtual Blue, a new plan that centers on virtual care for members with the goal of boosting access.

And with that first year on the books, the insurer is seeing positive results in Virtual Blue, it revealed Friday. Members were more likely to visit their primary care doctors compared to those in a more traditional PPO plan. Blue Shield saw primary care claims increase by 31% in 2023 compared to 2022 among people who switched from a more traditional plan to Virtual Blue and who had a virtual visit with a provider.

People who enroll in Virtual Blue are able to secure virtual visits with a $0 copayment and can schedule appointments online with their clinician, making it easier to fit critical visits into their daily lives. In-person care is available whenever appropriate or when the member prefers, Blue Shield said.

Blue Shield of California teams with Accolade on new virtual-first plan

Nina Birnbaum, M.D., medical director for innovation acceleration at Blue Shield and a practicing PCP, told Fierce Healthcare that the team was aiming to "increase the bond to primary care," so the first-year results are encouraging.

"We think of it as added cost, but it's the kind of added cost that we wanted to see in the healthcare system, because it helps people build that long term relationship with their physician," she said.

As members embraced primary care visits, emergency care utilization declined, Blue Shield found. Emergency room claims for Virtual Blue members decreased by 11 percentage points more than those who did not use virtual care.

In addition, the virtual platforms allowed members to access appointments more quickly, with about two-thirds secured within a single day. The national average wait time for an in-person appointment is three to four weeks, according to Blue Shield.

The insurer also found that 85% of Virtual Blue members were screened for behavioral health needs during a virtual primary care visit. The plan offers integrated mental and behavioral health for members aged 4 and up.

Cost of care was also between 8% and 10% lower for Virtual Blue members compared to those who did not use virtual care, Blue Shield said.

Birnbaum said that one key takeaway for the insurer over the past year is that Virtual Blue is resonating with people beyond the market you'd predict would take to it. She said Blue Shield has seen "amazing traction" with school districts, unionized employers, gas stations and grocery stores.

People in service jobs, for example, appreciate the the flexibility of scheduling and the ability to secure appointments in a way that fits their schedules, she said.

"That's been a really inspiring lesson and one that we're trying to learn from and make this more available to people," she said.

With a year of promising results under its belt, Blue Shield of California is now mulling ways to continue making the plan available to more people. Birnbaum said that the insurer sees clear opportunity in markets beyond the employer space, such as Medicare Advantage and Medicaid.

Navigating healthcare is a major hurdle for patients of all kinds, and virtual options do make that process easier for them, she said.

"Our healthcare system is failing people," Birnbaum said. "It doesn't matter how good the care is, if you can't get in, you can't receive the benefits of that care."