When it came to figuring out how to best help Humana's Medicare Advantage (MA) plans in the early days of the COVID-19 pandemic, the company had to "rethink our role," said Humana Chief Medical Officer William Shrank, M.D.
That's because the MA population is particularly vulnerable in this health crisis, he said, speaking during Fierce Health Payer's Medicare Advantage's Evolution virtual event Monday.
"It’s caused us to really rethink a lot about how we do our work and how we support and interact with our members. It’s forced us to take a step back and think about how to ask the right questions, rethink our routine and rethink where care is delivered, rethink how care is delivered and really rethink our role in how we support our members during a time that there is an incredible amount of strain and incredible amount of uncertainty," he said
Among the biggest goals early on, Shrank said, was to remove barriers to care for potential COVID-19 cases as well as for medical care that shouldn't be put off.
"We've seen the private sector come together in really heartening ways to try to think about where the gaps are, where the fault lines are in our public health system and how to try to fill them and try to meet the needs of a population that we didn't have all the answers. It was impossible to have all the answers," Shrank said. "From our perspective, I think about it in terms of a sort of process. At the outset we were learning, we were really all learning, figuring out how do we make sure our members have access to testing, and that was supporting our members in a way to make sure we were protecting them."
For Humana, as well as other insurers, that included waiving cost-sharing for testing for COVID-19 as well as urgent care visits and emergency department visits where COVID-19 tests are delivered, he said. Humana also immediately waived cost-sharing for telehealth visits to reduce potential exposure of individuals through in-person appointments and later waived cost-sharing for primary care and behavioral health visits through the end of 2020.
"At a time of social distancing, we didn't want medical distancing," Shrank said.
Humana also looked at reducing friction points for providers, such as reducing utilization management prior authorization, that could slow the speed to care. The insurer also sent out 7.5 million kits with masks and information about how to access care safely, as well as home screening tests so members could avoid going to their primary care doctor for tests, he said.
Among the biggest changes early on in the Humana's response was to conduct more proactive outreach to members to ask more questions.
"We were asking our members what kind of challenges they were facing. What were their main concerns?" Shrank said. "It was clear right off the bat that there was such a profound level of concern about basic needs in their social context: Getting to the store to access food. Food insecurity was a big one. Social isolation for those who had an inability to see family and friends. Behavioral health concerns that were rapidly exacerbated, and we weighed in pretty heavily early realizing we had to redirect our resources for so many of our members to address those basic needs."
The payer created what it called its "Basic Needs Team," which focused on building local resources within different markets to help address some of those needs of members at scale.
It also had to rethink some of the partnerships it offered to members that no longer worked in the context of the pandemic. For instance, it works with the company Papa to connect its "pals" or "grandkids on demand" with seniors, who meet in person to combat social isolation or help with light housework or immediate needs. They had to quickly pivot to a telephone-based approach, he said.
"We, like others, really took a step back, we took a hard look at what our member's needed and I think we were pretty nimble and flexible to address those needs rapidly," Shrank said.