Healthcare IT Allows Patients to Break Out of Set Provider Networks

Customer support operator working in an international call center. Health IT breaking out of provider networks.From being forced to schedule medical appointments months in advance due to the increasing demand for a decreasing number of providers, to completing repetitive questionnaires and spending hours in the waiting room upon arrival, accessing healthcare is a frustrating experience for most. But beyond the inconvenience of long wait times and too much paperwork, one of the most serious sources of patient frustration remains:  the inability to see a provider of their choice due to provider networks that are set by health insurance companies.

The stringent restrictions imposed by health insurance policies require patients to see a local “in-network” healthcare provider regardless of whether that provider is the best choice for addressing his or her particular health condition. Most of the time if a patient chooses to see a provider who is out-of-network, the cost of the visit is drastically higher than it would have been to see an in-network provider. This is a major deterrent to patients seeking doctors who are out of their network, sometimes preventing access to specialized care that may be required to adequately address a patient’s particular health need.

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The inflexibility and inconvenience imposed by the current healthcare system not only creates a serious obstacle for numerous patients who want to see their preferred provider, it also limits the number and range of patients that doctors can see. Fortunately, recent advances in healthcare IT are increasing patients’ ability to choose their provider – regardless of set networks and without high cost penalties for going out-of-network.

Virtual Visits: Consult with Any Provider, Anywhere

Digital solutions now afford patients the ability to consult with specialists from around the world— directly from their mobile device if they’d like, benefiting both patients and providers, as doctors have more time to provide quality care when they aren’t traveling between rooms to provide it and patients have more convenient ways to receive it.

These telehealth options also allow patients to break out of set provider networks. Virtual visits offer them the ability to connect with any provider anytime, anywhere, so they are no longer limited to doctors who are within a close geographical distance or in their predetermined provider network. Virtual visits also allow patients increased control over their own healthcare, granting them the power to choose which doctor to see along with a greater degree of flexibility and convenience for when, where and how to do it –a win-win scenario for all.

Improved Care for Rural Patients

While virtual visits enable patients to break free of the restrictions imposed by provider networks, improvements in healthcare IT offer an additional benefit for patients who live in rural areas: a recent report released by Modern Healthcare detailed the embrace of telehealth by insurers, stating that “nearly all payers now believe telehealth will help rural members access providers.”

Regardless of geographic location, telehealth is making it possible for patients to expand their provider network without breaking the bank when it comes to the cost and time associated with traveling to see a provider. Rural patients in particular, who have grown all too familiar with limited choices and inconvenient access to traditional healthcare, are likely to find telehealth options especially cathartic.

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