What does high quality, trustworthy V1C look like? Explore the IMPACT Core Competencies framework to discover what good V1C looks like and how to get there.

Produces outcomes that are valuable to key stakeholders View Resources
Delivers an ethical, equitable, and safe digital experience View Resources
Minimizes implementation and operational frictions View Resources
Fits seamlessly within an individual’s larger healthcare context View Resources

Core Competency: Administrative Efficiency

Minimizes implementation and operational frictions

V1C is a rapidly expanding field crowded with innovative first to market and fast follower solutions. The ability to execute–efficiently, consistently, and with clinical rigor–distinguishes the top companies from those who will not scale beyond an initial niche market.

Outstanding V1C entities are adept at balancing innovation and rapid cycle improvement with clinical and professional rigor. This enables them to attract and retain top clinical workforce talent, manage to market-leading quality, access and patient satisfaction targets, and adopt a flexible approach to partnering with health plans, other providers and employers.

Choose a stakeholder to see their perspectives on Administrative Efficiency.

Efficiency is apparent to patients by the absence of onerous and duplicative administrative forms, ease of receiving support, scheduling options, and an outstanding payment experience.
Clinical workforce satisfaction is tied to efficient workflows that free them from burdens of administrative work and enable them to practice patient care ‘at the top of their license’. Value-add operations include support in credentialing, licensing and training, and flexible work schedules.
Health plans value V1C partners who demonstrate a clear understanding of how their solution fits into existing health plan or employer benefits products, and bring a flexible and collaborative approach to contracting, implementation and performance improvement that minimizes cycle time and administrative costs.
An efficient and compliant operating model ensures that a venture can scale, and continue to improve cost structure with scale without compromising patient experience, quality, and access.

Third-party payer deals and reimbursement is becoming critical to establish V1C as a new standard of care that is accessible at scale and is a natural progression for V1C solutions that may have started out in the direct-to-consumer market. Positioning for third-party payer contracts requires a clear understanding of the alignment between the payer’s systems and processes around new modalities of care.

To streamline contracting, it is important that contract discussions start with a shared definition of V1C solutions as healthcare providers as defined in federal regulations, and are thus Health Insurance Portability and Accountability Act (HIPAA)-covered entities with the same obligations to patients as brick and mortar providers.

Ability to submit claims to insurers or third-party administrators (TPAs)*, regardless of desired payment model (fee-for-service, bundled payment, or risk-based) to facilitate analysis and explicit tracking

  • Flexibility in collaborating with partners to optimize coding and payment structures

Ability to collect payments for member responsibility in a secure, efficient way, with satisfactory member experience

Willingness to enter into fee-for-service arrangements as an on-ramp to more complex contracts if necessary

Positioned for outcomes-based arrangement (e.g., performance guarantees)

Positioned for entering into 2-sided risk-sharing arrangements with payers and other partners


Marketing and outreach processes and materials–digital or otherwise– are HIPPA compliant and designed to safeguard against any transparent implication that enables entities other than the intended recipient to attribute a condition to the recipient.

  • When promoting services in partnership with or on behalf of health plans or employers, use of the appropriate business associate agreements (BAA) and patient consent, when necessary

Proven record or logical pathway to identifying, reaching, and enrolling eligible participants


Ability to scale practice broadly:

  • ‘50-state solutions’ are highly desirable for national health plans and large employers
  • Credentialing process and documentation is compliant and auditable by partners
  • Providers are credentialed in multiple states

Health coaches are certified by relevant specialized programs, e.g., CDC-recognized diabetes prevention program (DPP) coaches or Certified Diabetes Educators (CDEs).

Uses multifactor provider identity authentication

Provider model enables patients to interact with the same provider, if desired.


Adheres to well-documented practice guidelines aligned with evidence based clinical quality and safety standards

  • Audits clinical practice against established care protocols and clinical guidelines (e.g., regular chart reviews) and can provide evidence of consistent quality and safety
  • Protocols in place to document and manage adverse events

Ability to provide real-time feedback on performance to clinical staff as a complement or replacement for retrospective audits

PDF Download

Guide to Virtual First Care (V1C) Payment Models


IMPACT V1C Payer Contracting Toolkit


Payer-V1C Guide to Contracting

PDF Download

Virtual First Care (V1C) Coding Library