Providers and third-party service companies want to deliver accessible and convenient care that has an impact.
Virtual care management, relying on telehealth solutions, can help engage patients in remote areas or who have physical, financial, or behavioral barriers to being seen in person. Certain programs, such as Medicare’s Chronic Care Management, can help address the needs of those living with multiple chronic conditions and can be performed almost entirely remotely.
In this article, we’ll review what virtual care management is, the role of a virtual care manager and how this approach contributes to cost-effectiveness and better outcomes.
What is virtual care management?
Virtual care management involves using technology to remotely monitor, engage with, and coordinate healthcare services for patients. These services are delivered digitally outside the typical in-clinic or in-person appointment.
The types of services offered include a host of care coordination activities and can include:
- Chronic Care Management
- Disease management
- Medication reconciliation and management
- Care coordination among healthcare providers
- Monitoring vital signs via Remote Patient Monitoring
- Patient care planning and goal setting
- Motivational interviewing and health coaching
- Patient engagement and education
- Self-management support
- Community referrals and resources
Virtual care management can incorporate real-time interactions, asynchronous communication, and passive remote monitoring.
What is the virtual care manager’s role?
Similar to a more traditional, in-office care manager, a virtual care manager helps patients manage their acute or chronic health conditions. They coordinate medical treatment, administer assessments, develop care plans, monitor medication compliance, and act as a trust advocate and coach.
In many ways, they serve as advocates for patients, helping them solve problems and remove barriers to maintaining the treatment plan and achieving their health goals.
The main difference is that a virtual care manager uses digital technologies to engage, communicate, and coordinate with patients and other providers or community resources.
What types of technology does a virtual care manager use to support patients with chronic diseases?
A virtual care manager can use a host of digital technologies and approaches that support ongoing patient communication, education, and engagement, including:
- Phone calls
- Secure texting
- Patient portal messaging or live chat
- Online forms and forums
- Videoconferencing
- Remote Patient Monitoring (RPM)
The best approach or communication tool will depend on the patient, their access and comfort with technology, the nature and stage of the relationship and the type of information exchanged.
While most of these technologies are focused on real-time or asynchronous communication, RPM utilizes integrated devices that collect and transmit patient clinical data via cellular- or Bluetooth-connected devices.
RPM devices include wearable and standalone devices, such as blood pressure monitors, glucose meters, smart scales, and pulse oximeters.
By monitoring and transmitting a patient’s vital signs and other health data, software, such as ThoroughCare, can flag outlier data points and alert care team members for review and possible intervention.
How does virtual care management contribute to care efficiency and cost-effectiveness?
Virtual care management contributes to care efficiency and cost-effectiveness by enhancing a patient’s access to ongoing health support. This not only reduces the need for in-person visits but also provides a more profound and more impactful approach to chronic disease management.
It also facilitates quicker and more responsive communication between patients, providers, and care managers. Ultimately, better access, deeper engagement and ongoing oversight can lead to lower healthcare expenditures in the short and long term.
Virtual care management supports patients with mobility or transportation issues, making care more convenient and less burdensome. This can lead to improvements in adherence and satisfaction as demonstrated in research published in the journal Primary Health Care Research & Development. Meta-analysis and systematic reviews of 24 studies round strong evidence for care management's effect, increasing adherence to treatment guidelines, and improving patient satisfaction.
MetaPhy Health: a virtual care case study
One example of the value that virtual care management offers via service providers is MetaPhy Health.
Since 2017, MetaPhy Health has used ThoroughCare as its comprehensive care coordination platform. The company delivers virtual Chronic Care Management and Remote Patient Monitoring to more than 24,000 patients across 50 gastroenterology practices.
As a 100% virtual care management service, MetaPhy Health submits nearly 35,000 virtual care claims per month.
“What we most often hear from patients is that the program allows them to be educated on things that their physicians may not have time to cover,” Ashley Stanley, Director of Clinical Operations at MetaPhy Health said. “They are provided a nurse, and they really appreciate that dedicated support and resource. That can provide an extra layer of care in between office visits.”
MetaPhy Health supports patients and its partner providers nationwide with:
- Clinical expertise
- Evidence-based assessments
- Digital care coordination workflow
- Patient engagement and education tools
- Data analytics and performance reporting
Value-based care and telehealth
Value-based care (VBC) incentivizes providers to take greater responsibility for care quality, cost, and outcomes. VBC emphasizes outcomes as a method to determine compensation.
One of the primary tools used in value-based care models, such as Accountable Care Organizations, health plan-health system partnerships, or other alternative payment contracts, is through coordinated care.
Virtual care management enables remote care coordination, empowering care managers to engage patients using digital technologies. Through ongoing, consistent, and cost-effective touchpoints, value-based care can:
- Provide patient oversight
- Impact health outcomes
- Avoid costlier healthcare channels
- Reduce admissions
How could the end of telehealth waivers affect virtual care management?
The American Relief Act, passed at the end of 2024, extended many telehealth waivers for three months. These waivers, which removed specific regulatory requirements, were originally passed at the beginning of the COVID-19 pandemic. Congress enabled the immediate expansion of telehealth services at that time to ensure quick, reliable access to care.
Without congressional action, these waivers will expire on March 31, 2025.
The possible expiration of the telehealth waivers would primarily impact telemedicine visits, where a physician provides direct care to patients via videoconferencing technology; however, there should be minimal direct impact on virtual care management services.
Virtual or non-face-to-face care management programs, such as Chronic Care Management, Remote Patient Monitoring and Behavioral Health Integration, may only need to make operational adjustments.
How ThoroughCare enables virtual care
ThoroughCare equips virtual care managers to carry out all aspects of their duties through proven, reliable standards, systems, and workflow. Virtual care managers can use ThoroughCare to create an impact with patients.
ThoroughCare helps providers, based on their specific needs, build new virtual care programs or scale existing services. We support a comprehensive software platform, clinical advisory expertise, and reporting tools for quality improvement.
ThoroughCare offers:
- Comprehensive care planning tools
- Evidence-based assessments (lifestyle, health risks, behavioral conditions, SDOH)
- Automated billing code assignment with audit trail
- Data integration across EHRs, HIEs, remote devices, and advance care plans
- Analytics to report on care performance and operations
Key Questions Answered
What is virtual care management?
Virtual care management is similar to traditional care management, except it uses technology to monitor, engage with, and coordinate healthcare services remotely. These services are delivered digitally outside the typical in-clinic or in-person appointment.
Virtual care management services deliver care coordination activities, including:
- Chronic Care Management
- Disease management
- Medication reconciliation and management
- Care coordination among healthcare providers
- Monitoring vital signs via Remote Patient Monitoring
- Patient care planning and goal setting
- Motivational interviewing and health coaching
- Patient engagement and education
- Self-management support
- Community referrals and resources
What types of technology does a virtual care manager use to support patients with chronic diseases?
A virtual care manager may use a variety of digital technologies and approaches to provide ongoing patient communication, education, and engagement. These may include:
- Phone calls
- Secure texting
- Patient portal messaging or live chat
- Online forms and forums
- Videoconferencing
- Remote Patient Monitoring