Employers have spent the last several years adding access points to their benefits ecosystem—telehealth, symptom checkers, on-demand chat—trying to close gaps in care. Yet more than a quarter of U.S. adults haven't seen a primary care provider in the last year because they simply couldn't find the time. Time away from work, long waits, and administrative hassles can stand in the way of preventive care and timely treatment.
That's the paradox benefits leaders face: more access hasn't meant better outcomes. Without a connection back to a trusted provider, another access point just becomes another standalone, siloed solution—access without the continuity that moves outcomes or cost.
Marathon Health takes a different approach: advanced primary care (APC) built around a trusted provider relationship, with digital access points designed to strengthen that relationship rather than compete with it. This continuous primary care model accounts for all elements of a person's health, with digital tools so care can match the day the member is having. That might look like an eVisit during a work break, texting a provider between meetings, or using an AI chat to refill a prescription on the weekend. With minimal disruption to members' lives, resources like these can increase engagement with primary care even further, which is proven to lift outcomes and drive ROI for plan sponsors.
In a recent interview, Dr. Aasha Trowbridge, Marathon's medical director of virtual care, spoke to ways the right digital tools can strengthen care continuity while helping members manage their health before, between, or after in-person visits.
Personal relationships, accessible anytime
Q: Members encounter a lot of fragmented technology: apps, portals, websites, and more. How does Marathon expand its options for digital care while keeping it simple to use?
Dr. Trowbridge: Our goal behind continuous primary care is to design around the patient's journey—rather than around separate, disconnected tools—so care is easier to navigate and stays coordinated however patients access it. In practice, that starts with one front door.
Along with in-person visits, patients can see a Marathon provider by video or phone, and they reach those visits from the same portal or app. Patients might also choose to engage with us asynchronously through channels like text-based care or eVisits that don't require a live interaction.
Q: How do digital tools integrate with Marathon's advanced primary care model, which encourages strong patient-provider relationships and continuous care?
Dr. Trowbridge: We use technology to strengthen the patient-provider relationship, not replace it. Because patients can see the same provider in the health center or virtually, and because digital encounters are routed back to that provider, each touchpoint builds on the last instead of starting over. For example, a patient might see their provider in person for a preventive visit, follow up by video after a diagnosis, and send their provider a secure message through the portal for non-urgent questions along the way.
Engagement grows when care is easy to reach. Patients can choose the continuous primary care option that fits their day. Whether that's an in-person visit, a text message, or an eVisit for an acute concern, they're more likely to reach out early instead of putting it off. Patients who feel known by their provider also have more reason to come back and use our advanced primary care services as their first stop for health needs.
Guided care and provider oversight
Q: How does a primary care provider stay in the loop across a member's care options?
Dr. Trowbridge: When a member chooses to engage with us asynchronously—that is, without a live interaction—their provider is always kept in the loop. Let's take eVisits, for example. During an eVisit, the patient submits a digital symptom assessment, a Marathon provider reviews it, and provides a care plan back within four hours.
Once an eVisit is complete, the encounter is sent to the patient's usual provider to review, and everything is recorded in the same electronic health record. Text-based care, designed for quick questions and acute condition management, works the same way.
Q: What safeguards are in place so members with something more serious are escalated appropriately?
Dr. Trowbridge: Before an eVisit starts, patients choose from a list of low-acuity conditions and symptoms, so eVisits are limited to the kinds of concerns that can be safely handled without a live encounter. Our platform has built-in guardrails to help flag concerns that shouldn't be handled through an eVisit. If a patient's concern is flagged as unsuitable, they're guided to schedule a live visit instead, ensuring they still get timely care.
A provider reviews every eVisit and uses clinical judgment. If the concern needs more than an asynchronous exchange, the provider can step up the eVisit to direct texting, a phone call, a video visit, or an in-person appointment.
Expanding the possibilities of remote care
Q: Are there situations where virtual care is a great resource that patients might not consider?
Dr. Trowbridge: Many patients think of virtual care as a backup for minor issues, but CareAnywhere, our virtual advanced primary care solution for employers, can manage the majority of primary care conditions. Chronic conditions like high blood pressure, diabetes, and asthma need regular follow-up—and much of that conversation doesn't require an exam room. Medication refills, dose adjustments, and questions about side effects are easy to handle by video, phone, or text. Following up after an emergency room visit or hospital admission can also happen virtually.
In preventive care, providers can perform a virtual exam with the patient's assistance, review lab results, and address age-appropriate screening plans. And when a member's needs go beyond primary care—occupational health, musculoskeletal issues, more involved mental health support—Marathon coordinates that too, so the same provider relationship stays at the center. Patients can also work virtually with health coaches and dietitians on day-to-day habits behind their health, or mental health providers for full spectrum care from a private, comfortable place—which can make it easier to seek help for stress, anxiety, sleep, or mood concerns they might otherwise put off.
Q. What is the biggest misconception benefits leaders have about virtual and digital care right now?
Dr. Trowbridge: The biggest misconception is that virtual care is an add-on—a separate tool layered on top of "real" primary care. In fact, virtual care can provide advanced primary care.
What matters most is whether the different ways to get care connect. Sometimes organizations end up with so many point solutions—third-party telehealth, symptom checkers, redundant portals—that the care journey gets harder, not easier.
Patients do best when it's simple to find the right option and their own provider stays informed about the care they receive, whatever channel they use. Leaders shouldn't ask only, "How many ways can members access care?" They should ask, "Do those ways connect back to a provider who knows the member?"
Giving patients the care they need, where and when they need it
This is what continuous primary care looks like in practice. Marathon Health members have even more ways to reach their care team between visits, all routed back to the same provider relationship:
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eVisits: Members submit a digital symptom assessment at their convenience and receive a diagnosis and care plan for routine conditions within four hours, no visit required.
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Text-based care: Members securely connect to a centralized clinical care team to assess, diagnose, and treat acute conditions—with all conversations coordinated back to the member's primary care provider.
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Text-based support: Lucy, Marathon's AI-enabled virtual assistant, offers instant answers for routine requests like appointment information or prescription refill requests, with more complex questions escalated to the Patient Support Team.
For employers and labor organizations, the strategic case is straightforward: every barrier removed is a chance to engage a member earlier, before a manageable issue becomes an expensive one. In Marathon's eVisit pilot, 98% of members whose first touchpoint with Marathon was an eVisit went on to establish ongoing primary care—turning a single interaction into a lasting relationship, and a lasting relationship into lower utilization and cost over time.
Contact us to talk through what continuous primary care could mean for your population's engagement, outcomes, and cost trend.
