Tuesday, March 17, 2020

6 things Medicare Advantage health plans must do in response to the coronavirus


Ilene MacDonald, Editorial Director | March 17, 2020
The coronavirus is spreading so quickly throughout the United States and the rest of the world that the response to the outbreak seems to change by the hour. Make sure your organization is in the best position to keep operations running smoothly and ensure that your members—who are among those at higher risk of becoming seriously ill from the virus—know they can rely on you for helpful, accurate, and the most up-to-date information.
People are being inundated with news about COVID-19 from the national, state, and local media as well as social media channels. But many Medicare Advantage (MA) health plan members fall into the high-risk categories of the illness and need more personalized information than what they receive in general news articles. This is where your organization needs to take the lead.
“This is an opportunity for plans to get out front of the situation with proactive communications for their members and it’s also an opportunity to become a trusted partner in their health,” says Kathleen Ellmore, managing director of Engagys, a health care consumer engagement consultancy and a member of RISE’s Medicare Member Acquisition & Experience Advisory Board.
She suggests that all MA plans should have a call to action on the main landing page of their websites asking members to submit their email if they would like to receive regular updates on COVID-19. This will allow plans to send personalized information to higher-risk members to help them interpret the developments they are seeing on a larger level, explaining what those latest developments mean to them. At the same time, plans can collect consent and contact information to email their members as part of regular outreach inf the future.
Ana Handshuh, CHC, principal, CAT5 Strategies, and a member of the RISE Executive Committee, agrees. “You can’t be passive. Think about how to encourage your high-risk members to follow behaviors to prevent transmission,” she says.
Anticipate what they need to access care, medications, or durable medical equipment, such as oxygen and other supplies. “The more you can coordinate in advance, the better,” Handshuh says.
Here are some other steps you can take:
1. Adopt a multi-prong approach to communication. Provide information to members via your website, in email communications, and by training your call center representatives so they are in a good position to answer questions, such as “What are the symptoms of the coronavirus?” and “Where can I get a test?” “The answers should all be scripted,” says Handshuh.
Furthermore, if you instruct your call center representatives to tell members to call their doctors, make sure you are aware of the capacity of your providers. You may need to help your network by disseminating updates to them. Handshuh says it’s important to coordinate responses, the sooner the better. 
Among the messages: Alert members on what they need to know and do to prevent community spread, so they stay home and avoid social gatherings. “Explain to them the importance of social distancing so we can flatten the curve (which slows the spread of the illness, so hospitals aren’t overwhelmed with patients),” she says.
“Because information about the outbreak changes so often, update information daily,” Handshuh says. Good resources for members include the coronavirus information pages of the Center for Disease Control and Prevention and World Health Organization. In addition, providers and  plans can find helpful information at the CMS current emergencies page and CMS guidance on coverage and payment related to COVID-19. Plans should also access the web resources of their local and state health authorities for the most updated information in their areas.
2. Post FAQs on your site. Every health plan should also have a frequently asked questions (FAQs) page on their site that explain what they are doing in response to the coronavirus. Now that the Centers for Medicare & Medicaid Services (CMS) has relaxed guidelines so MA and Part D plans can waive certain requirements to help prevent the spread of COVID-19, Ellmore says that plans need to outline what they are doing proactively. For example, let members know if you are eliminating copayments for COVID-19 tests, offering home delivery for prescription medications, allowing early refills on prescriptions, and providing telehealth services with $0 copays.
Ellmore stresses that this is an opportune time to promote telehealth and any virtual care services that you offer. “Some organizations are stopping all home health visits, others are continuing with those visits but explaining the precautions they are taking, and others are offering on-demand services. Many plans are taking different approaches so it’s critical that you communicate the actions you are taking,” she says.
3. Ensure members get appropriate access to care. Handshuh recommends that MA plans make sure they eliminate any financial hurdles that would prevent members from receiving necessary care. For example, you may want to eliminate copays and deductibles for people who are quarantined for COVID related care, set up rapid testing for them, and expand telehealth benefits so members don’t necessarily have to leave their homes to receive care.
“Make sure you understand the requirements and how your plan handles different types of care access, like a doctor’s office, urgent care and the ER,” Handshuh says. If you no longer require referrals, make sure your network of providers is aware of the revised policy. Also coordinate with providers so they are aware of the capacity of the local ER department and know the criteria for triage.
Because this is such a stressful time for people, Ellmore suggests that MA plans also promote virtual mental health options alongside their other mental health services. Isolation and loneliness are well-known social determinants of health on their own. The stress of the outbreak and need for social distancing may exacerbate the situation for some members. “This is also an opportunity to explain tactics outside of what your plans offer, encouraging people to disinfect their phones and call their senior family members and neighbors. Promoting virtual interactions can help keep loneliness at bay,” she says.
4. Have a contingency plan in place. Set up an emergency operation to prepare for any disruptions to your operations, Handshuh suggests. For example, if you had to close your workplace, what would you do? How would you carry on your day-to-day operations? Which functions are critical? Which can be performed by employees working from home? Some organizations have a business contingency plan for natural disasters, but few have set up plans for a global pandemic. “Certainly, some places like Florida and California tend to have more in place but not for events sustained over a long period of time,” she says.
5. Work closely with state and local authorities. All MA plans should have channels of communications with their state and local departments of public health. “Plans shouldn’t be finding out new information at press conferences,” Handshuh says. She also recommends that plans work with one another and share information and coordinate efforts so they can be prepared for worst-case scenarios. 
6. Consider the use of free tools to help with your planning and communication. For example, Carrot Health has just released a free public resource that identifies the populations most vulnerable to the critical form of the virus. The company said it is making the COVID-19 Risk Dashboard resource freely available to help inform intervention and public health decisions at the national, regional, and community levels.
CareSignal is also offering a free use of a tool for providers to communicate directly with their patients regarding COVID-19 because patients want to hear most from their own physicians. The COVID Companion program was designed to help providers connect patients with local health resources and share CDC recommendations.

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