The Covid-19 pandemic has spurred a dramatic increase in virtual health care in the United States. The rise has been driven by the need for social distancing and enabled by a wide range of policy flexibilities implemented by federal and state legislators, regulators, and payers. However, many of these allowances are temporary. As the pandemic ebbs, policymakers and payers are deciding whether and how much to pay for virtual care services in the future, leaving clinicians uncertain about whether they will be able to afford to continue their virtual care programs. But parties are often making these decisions based on outdated or limited measures of success that do not holistically reflect the realities of how value is being generated.
To address this need, the American Medical Association (AMA) and Manatt Health, a legal and consulting firm, have developed a framework for assessing the value of digitally enabled care. It accounts for the various ways in which virtual care programs may increase the overall “return on health” by generating benefits for patients, clinicians, payers, and society going forward. The framework can be used by care providers to develop and evaluate new digitally-enabled-care models, by payers to inform coverage and payment decisions, and by policymakers to establish regulations that guide the future of virtual care.