HR must navigate inconsistent access between public virtual care and private platforms
Virtual health care usage increased sharply during the COVID-19 pandemic, supported by temporary policy changes that enabled remote delivery of primary care. However, as then-emergency measures have been revised or withdrawn, access to publicly-funded virtual care now varies significantly across provinces and territories, according to recent report.
The report released by the C.D. Howe Institute describes how virtual care shifted from a marginal tool to a widespread mode of service during the pandemic, with more than 70 per cent of primary care visits conducted virtually at the peak of the crisis, enabled by new billing codes for phone and video encounters.
For employers, and particularly HR leaders managing national workforces, these policy differences affect how consistently employees can obtain timely primary care and related services.
Uneven rules and access across Canada
During the early pandemic response, provinces supported the transition for healthcare providers from in-person visits to virtual care in order to maintain services while reducing infection risk and preserving in-person capacity for those requiring physical assessment.
Subsequently, provincial governments adopted different approaches to integrating virtual care, according to the report. It found that some jurisdictions have incorporated virtual primary care into their public systems, while others have restricted or modified policies, including billing codes and eligibility criteria. As a result, patients’ ability to access publicly funded virtual visits with family physicians or nurse practitioners now depends on local rules and remuneration structures.
Examples of this variation include whether patients can routinely see their regular primary care provider virtually at no out-of-pocket cost, whether virtual-first or virtual-only primary care models are able to bill the public plan, and whether an existing in-person relationship is required before a provider can bill for virtual care. These conditions influence access for people without an attached family doctor, including many working-age adults.
For national employers, the same benefits package can interact differently with provincial health systems, leading to different care pathways for employees in different locations.
Growth of private virtual care platforms
Where public coverage or provider availability is limited, private virtual care platforms have expanded. The report’s analysis of the virtual care landscape indicates that private-pay options have grown in areas where access to publicly-funded primary care is constrained or where patients face difficulties securing timely appointments.
These platforms typically offer on-demand visits with physicians or nurse practitioners, often arranged through employer-sponsored benefits. They are used to provide employees with remote access to clinicians across multiple jurisdictions and outside standard clinic hours.
The report suggests that improving publicly funded primary care and expanding virtual delivery could reduce demand for private services, as “demand for private services disappears with adequate supply of public ones.”
Finding the right balance for virtual healthcare
“Canada faces a healthcare access crisis, and virtual care has become an essential tool for enabling rapid access to primary care,” said Rosalie Wyonch, associate director of research for the C.D. Howe Institute and one of the authors of the report. “The challenge for policymakers is not to resist the growth of virtual care or to choose definitively between public and private models, but rather to ensure that virtual care serves the goal of affordable and equitable access to quality healthcare for all Canadians.”
Virtual care emerged as a key tool during the pandemic and, according to the C.D. Howe Institute report, continues to represent a significant shift in how healthcare can be delivered in Canada. For employers, the interaction between public policy and private virtual care offerings is now a structural factor in workforce health planning.
