Solutions-Focused Strategies to Improve Access to Care: Successes of a Virtual-Only Specialty Care Program

Rural and underserved patient populations often face significant challenges in accessing in-person care, which leads to delays and poor health outcomes. Waitlists for in-person specialty care can last up to six months. To overcome access issues, we developed and implemented a virtual specialty service line to increase access to specialty providers and reduce wait periods for specialty care. The innovative model provides “no-barrier,” 100% virtual care in high-demand specialties and primary care, while also coordinating referrals for in-person lab work, imaging and pharmaceuticals in the patient’s local community. A real-time, data-driven dashboard of program outcomes incorporates multiple data sources, including the electronic healthcare record, digital visit platform and patient engagement data sources, to inform program quality improvement and data-driven decision-making. Primary outcomes include utilization; provider productivity; downstream revenue; the proportion of new versus returning patients; patient satisfaction; patient costs associated with travel; and cancellation, rescheduling and no-show appointment rates.

The virtual specialty service lines include endocrinology, rheumatology, neurology, pulmonology, benign hematology, sleep medicine and primary care, serving both new and returning patients. From June 2023 to May 2025, 22,914 virtual specialty visits occurred among 9,676 unique patients. Endocrinology was consistently the highest volume service each month. In 2025, rheumatology, family medicine and gastroenterology schedule new appointments within a mean of less than six days. Over the last year, new patients accounted for 41% of the visits. Further, patients were largely insured by Blue Cross Blue Shield (42.8%), followed by Managed Care Organizations (17.5%), Medicare (16.9%) and Medicaid (13.8%).

Virtual specialty patients reside in zip codes statewide, saving considerable time and travel costs. Patient experience ratings are consistently higher for the 100% virtual practice, compared to hybrid in-person/virtual care. This session will share initial lessons learned on innovative program strategy and implementation, including the challenge of establishing a highly accessible digital front door and managing challenges associated with leveraging EHR tools. We will also compare and contrast telehealth services with in-person services in terms of the overhead and expenses associated with brick-and-mortar clinics, as well as staff savings compared to national benchmarks and internal metrics.