The reality of our current situation is filling many of us with healthy doses of anxiety and uncertainty. But I’m a firm believer in finding the good in situations. One such positive is how health plans, including many of our clients, have jumped in and acted quickly to ensure the needs of their members are met during the COVID-19 pandemic.
The following list of actions highlights many of the critical gaps that health insurers see emerging and are working to address, so that people can get care and coverage. This is by no means an exhaustive list of all the good work going on out there but includes some good examples:
- Removing barriers to testing: Not only are insurers removing pre-authorization requirements for testing, the office visit will also be covered along with any additional diagnostic testing that is medically necessary. This coverage also includes members of high-deductible health plans with HSAs.
- Making treatment accessible: Plans have waived member cost share (co-pays, co-insurance and deductibles) for medically necessary COVID-19 testing, counseling, vaccines (when available) and treatment and supportive care at doctor’s offices, urgent care centers and emergency departments (excluding inpatient care), in accordance with the Centers for Disease Control and State guidelines. Any medically necessary treatment for COVID-19 is covered under a member’s health plan within the United States or internationally.
- Providing extra support for members who need it most: From direct contact with high-risk members using case management services to personalized support for those confirmed to have the virus, there are plans working to provide personalized support for members that need it most, including in-home care options where needed.
- Waiving costs for telehealth: Many plans are increasing access to telehealth for members and temporarily waiving co-pays, co-insurance and deductibles for telehealth visits, including the entire BCBS Network. Telehealth can successfully reduce exposure risks for patients and providers while maintaining care services including urgent care, physical therapy, behavioral health, lactation support and nutrition counseling. As this crisis creates mental health struggles for thousands of Americans, behavioral health support in particular will be an incredibly important service to make more easily available to members.
- Reducing exposure by reducing trips to the pharmacy: Some insurers are waiving early medication refill limits on 30-day prescription maintenance medications to ensure individuals can skip monthly trips to the pharmacy and reduce exposure. Others have also worked with their pharmacy partners to provide free delivery of medications and assist with mailing prescriptions.
- Keeping staff safe while continuing service operations. Like many companies, several payers are sending their non-essential staff to work from home in order to keep business operations running and staff safe during the pandemic. Where employees are heading to the office, staggered work times and other social distancing protocols are being implemented.
- Funding community support: A few plans have announced large donations to efforts driven by community and nonprofit organizations supporting older people affected by the coronavirus outbreak. The donations will be used to provide access to food, at-home support, housing, transportation, medical supplies and other services, especially for older people and those most vulnerable.
How HealthSparq is supporting clients
As we see all the great work our clients and the health insurance industry are doing amidst the COVID-19 pandemic, our teams are working hard to support wherever we can. One of the biggest ways HealthSparq is helping our health plan clients and their members is by working to provide specifically targeted information that help members quickly find resources and identify their options for care amidst lock-downs and voluntary self-isolation.
Our analytics team has been watching for activity in HealthSparq One related to coronavirus search terms and, unsurprising, in the last 14 days we’ve seen searches increase almost daily. Our team quickly mapped these search terms to results, and helped our clients get virus-specific messages up quickly so members could access their plan’s coronavirus resources and information outside of HealthSparq One. We are also working closely with several plans to help them promote telehealth options to members.
The opportunity to deliver for members has never been greater
As this situation continues to evolve, the opportunities for health plans to more deeply engage with and support their members is bigger than ever. With all of the good things happening, people still aren’t getting the facts about their benefits. A recent survey showed that over half of all health plan members had not seen any communication from their plans on COVID-19 coverage or resources. Going above and beyond what state and federal requirements are dictating around COVID-19, plans can ensure their members can easily access their health plan whenever they need for information, tools or advice to address all aspects of their care. As plans build this new level of support for their members, they are simultaneously building trust that will last well beyond this current situation and could forever change how health plan members interact with their care and their health plans going forward.
Plans also have an opportunity to partner with their provider networks and employer groups more closely to distribute information, ensure needs are being met, and to identify and engage with the most at-risk individuals to ensure they are supported. These resources and support are needed more than ever as providers are overworked and employers are facing down an economic crisis in addition to a pandemic. There are some great steps for payers to consider in this Oliver Wyman article, as well as this one.
I’m optimistic that all the great work being done will not only improve crisis response in the future but will compound to deliver more value and a better experience for health plan members today. Plans are working quickly to meet the demand and need for services that have long been available to members but underutilized. I’m looking forward to seeing what comes next from health plans while as many of us as possible hunker down, socially distance, and do our best to support the health care professionals that are working so hard to keep us all healthy.
