Why a New Provider Collaborative is Going All-in on Hybrid Care

July 13, 2023 - Though telehealth use has fallen from pandemic highs, the care modality has remained popular among healthcare providers and patients. Now, health systems are tasked with implementing virtual care alongside in-person services to support the quintuple aim for healthcare.

A recent survey by Doximity, which polled 1,200 healthcare professionals and 2,400 adult patients, shows that perceptions of telehealth were positive overall. About 88 percent of physicians and 76 percent of patients agreed that telehealth increases patient access to care. Further, 85 percent of patients who had engaged in telehealth within the year prior said that their overall care was the same, if not better.

As health systems work to seamlessly integrate virtual care, new types of collaborations are needed to identify care gaps and develop digital solutions. This is one of the primary goals of Caire.

Launched by Northwell Health and Aegis Ventures earlier this year, Caire partners with health systems to build hybrid models of care supported by virtual care solutions. 

"Working closely with health systems through care coordination and deep technical integration with EMRs, Caire is building a hybrid model of in-person and virtual care to holistically meet the needs of patients," said John Noseworthy, MD, executive chairman of Caire.

Noseworthy, emeritus president and CEO of Mayo Clinic, will also lead the Caire Collaborative, which he describes as "central to the Caire thesis."

The collaborative is a consortium of health systems that will serve as investors, early adopters, and clinical partners for the Caire hybrid model, providing scale both nationally and regionally, he added.

Northwell Health, the largest health system and private employer in New York State, is Caire's first adopter and investor.

Caire's first virtual care solution, called Upliv, launched at Northwell Health last year. The solution provides telehealth services to address perimenopause and menopause symptoms. Through telehealth, users gain access to menopause experts and health coaches, prescription and treatment options, online resources, and patient communities.

According to Noseworthy, there was strong demand from the Northwell workforce for a solution that supports women during their menopause journey. An internal survey of 900 Northwell employees showed that most have experienced moderate to severe menopause symptoms, including hot flashes and fatigue, a health system press release noted.

The solution was initially offered to Northwell nurses and then expanded across the system. Eventually, Upliv will partner with employers to provide its services as an employee benefit.

This provides a blueprint of what the healthcare industry can expect from Caire.

"Caire is highlighting and cultivating a new healthcare model through collaboration," said Noseworthy. "Health systems are uniquely positioned to identify unmet needs, design effective solutions, and deliver care. There is nothing more powerful in the market today."

Health systems are also among the largest employers in the nation, he added, pointing to Northwell Health as an example, which is New York's largest employer with a workforce of more than 80,000 team members. Thus, unmet workforce needs within health systems impact a large swath of the US population.

"Employers nationwide are facing a workforce crisis, and health systems are no exception," Noseworthy said. "They face recruitment and retention challenges, with clinician burnout and turnover impacting health systems across the United States. Health systems need to care for caregivers to ensure the health of our communities."

Clinician burnout — a long‑term stress reaction characterized by several symptoms, including emotional exhaustion and depersonalization — soared during the COVID-19 pandemic. Research released last September shows clinician burnout reached 62.8 percent in 2021 compared to 38.2 percent in 2020 and 43.9 percent in 2017. Further, mean emotional exhaustion scores increased by 38.6 percent from 2020 to 2021, while depersonalization scores increased by 60.7 percent.

In addition, the pandemic exacerbated health system finances. A report from Deloitte earlier this year showed that health systems will likely continue to face financial challenges in 2023 as they grapple with inflation, staffing shortages, and low margins.

These are some of the problems Caire hopes to help healthcare providers solve through co-designed hybrid care models and virtual care solutions.

There is evidence supporting the notion that virtual care can help ease burnout and financial strain. The aforementioned Doximity survey, for instance, shows that most physicians believed that telehealth improved work-life balance, with 66 percent saying they experienced at least one benefit related to time management due to telehealth. Further, recent research has shown that employer-sponsored telehealth programs cost less than in-person care services.

According to Noseworthy, developing solutions alongside the systems that will implement them ensures that they are clinically rigorous and uniquely suited to address the needs at hand. Additionally, the ongoing financial challenges facing health systems have already prompted the move from traditional acute care settings to alternative care sites, making virtual care a natural next step in the evolution of care delivery models.

However, partnering with hospitals to co-design solutions is not only important because providers are best suited to identify the challenges they are facing but also because collaboration will help equip them to address competition from non-traditional entrants into healthcare.

"New entrants such as retail companies like Amazon and CVS have innovated new care models that threaten to fragment care for patients," Noseworthy said.

But he added, "Health systems bring many strategic advantages that other players do not have. This includes clinical leadership, data, access to the frontline, and trust from the patients and communities we serve."

Thus, Caire's primary goal is to engage health systems to develop their own solutions to overcome persistent challenges. Caire's next steps include launching additional solutions in the women's healthcare space as well as in the chronic disease management arena.

As the US healthcare system evolves in a post-pandemic world, healthcare provider organizations must identify gaps in care access and delivery and not only close them but keep them closed. According to Noseworthy, collaboration is critical to this endeavor, and time is of the essence.  

"We must act now or risk being too late, allowing others to dictate how care is accessed and delivered," Noseworthy said. "These other players have shown they do not always do what is best for patients and are not in it for the long haul. Health systems must answer that call."