Health plans make it easier to access care during the pandemic - but are their members reaping the full benefit?

The global health emergency we are experiencing has put our country’s healthcare system under a microscope, and exposed deficits our elected leaders are scrambling to address.

But we’ve also seen inspiring instances of people pulling together to help one another. Doctors and nurses have been working double shifts in difficult circumstances, and local governments and workplaces have implemented policies that sacrifice short-term financial gain to keep as many people healthy as possible.

Health insurance providers are also doing whatever they can to help millions of patients during the crisis. Whether they’re making it easier for members to consult with a doctor or to stock up on medication without having to visit the pharmacy, many payers are taking pressure off of patients during the pandemic by removing barriers to care.

Payers--who are the financial engine for much of the activity in healthcare--have an important role to play as our country tries to care for people during a crisis. It’s great to see that health plans have stepped to the plate.

Here are just a few examples of initiatives that health plans have undertaken that will help their members stay healthy no matter how the pandemic changes the day-to-day realities of healthcare:

Blue Cross Blue Shield of Michigan

• The plan is covering the cost of visits with telehealth providers for both medical and behavioral health consultations. Members are also offered a range of no-cost care options if they are diagnosed with COVID-19.
• For eligible medications whose prior authorization expires before June 1, the health plan will extend the deadline until August 1.
• The health plan is also accelerating payments to Michigan-based physician organizations and practices to support their efforts for treating patients with COVID-19.
• BCBS Michigan is waiving refill limits on 30-day and 90-day maintenance medications and encouraging members to use 90-day mail-order prescriptions.

 Blue Cross Blue Shield of Arizona

• This health plan has waived copays and coinsurance for COVID-19 testing, as well as prior authorization for diagnostic tests and covered treatment services deemed medically necessary and consistent with CDC guidance for members diagnosed with the virus.
• BCBSAZ has also waived all copays, co-insurance, and other cost-sharing related to COVID-19 treatment from in-network providers through May of 2020.
• The health plan has also increased access to telemedicine for its membership.

Robust engagement with members now a must

These locally operated BCBS plans are just two examples out of dozens. Health plans of all sizes, including Aetna, Humana, and Anthem, have launched comparable programs to help members gauge their risk of contracting COVID-19 get questions answered about symptoms, access the medications they need, and consult with physicians via telehealth platforms.

It’s inspiring to see how quickly business models can adapt when it comes to helping people during uncertain, anxious times.

These health plans should keep in mind, however, that these programs will only help their members if the members are aware of them. While many health plans are posting coverage updates on their websites—and others are flooding members with general information about the virus--this is likely not enough when it comes to getting the word out.

Health insurers who want to ensure they are reaching significant numbers of members should partner with the technology companies that have demonstrated they are adept at engaging consumers. To that end, the companies that most adeptly engage with consumers tend to not simply engage for the sake of engaging.  

The mechanism of communication can also vary across these technology companies. Some of these companies facilitate two-way conversations via text message or other channels with consumers, while others use mobile technology to push out important information on managing health or offer discounts on prescription drugs.

What questions should health plans ask if they use technology partners to help reach members.

Just about any technology partner can text-message or call members – but what are they saying when they make contact? Are they offering something of value, and are they communicating in the channel that each member prefers? At the end of the day, are they making healthcare more convenient or more affordable?

Health insurance companies don’t get the same attention as the front-line healthcare workers who are scrambling to save lives, but they have made significant moves to extend care to tens of millions of people, whether they’ve contracted the virus or not.

Now, it is more important than ever for these health plans to evaluate what they need to do to ensure that their members are in the know about the updated services and benefits that have been made available to them.