Pandemic Offers Lessons for Payors, Health Plans
By Karen Blum
The COVID-19 pandemic has had a major economic impact on the health care system but also offers a number of lessons that health systems and payors can take forward in preparing for future epidemics or a resurgence of COVID-19, experts said during a webinar sponsored by Impact Education.
“There is a lot of opportunity to be optimistic about how our health system will improve as a result of COVID,” said Peter Watson, MD, the vice of care management, quality and outcomes for the Health Alliance Plan, a nonprofit plan based in Michigan, said. Many areas within health care systems struggled with the unexpected during the pandemic surge this spring; all can be looked at as opportunities for improvement going forward, he said.
Hospitals had a lot of extended waits for COVID-19 test results in the beginning of the pandemic. As a result, they had to act in a manner that presumed patients were positive and use personal protective equipment, and it was difficult to cohort infected and noninfected patients because it was unclear who was who, Dr. Watson, who also is an attending staff hospitalist at Henry Ford Medical Group, in Michigan, said.
There also were issues with shortages of specialized providers needed to manage patients. At Henry Ford, the graduate medical education director repurposed all training staff to care for COVID-19, which demonstrated that health systems can be nimble.
“As payors, we have to be very supportive of our health systems that are trying to react very quickly in these situations,” he said.
Hospitals also faced shortages of certain equipment, such as ventilators and infrared thermometers. “These are things all facilities are now rethinking, and as health plans we will have to partner with our facilities to make sure they have the resources they need to take care of our membership,” Dr. Watson said.
In addition, health systems have been working to try to stay financially viable, he said, continuing to provide needed care and working to try to make sure staff are paid and deployed properly. Many had to make changes in their lines of credit or apply for government or other loans. Some hospital groups have since started working together to pool supplies and make sure they have enough inventory on hand for the next outbreak.
The pandemic opened discussions about fair allocation of resources, Dr. Watson said. While much of that had to do with ventilators, it opens the door for conversations about how COVID-19 vaccines should be distributed if and when they are approved and appropriate.
“Getting the vaccine is just one step,” he said. “Getting the vaccine to the people who need it will be an entirely different issue. As health plans, we will have to partner with health care organizations to make sure it’s done fairly and appropriately for our population.”
Multiple Points of Support
The virus shed light on other areas health plans can be involved in, he said, including testing for their members and the broader community, and supporting member needs outside of clinical care, such as providing food benefits. It also highlighted opportunities for health plans to partner with clinical systems to address risky chronic conditions—such as obesity, hypertension and diabetes—that exacerbated COVID-19 clinical outcomes and deaths, Dr. Watson said. “These should be areas of intense focus as we prepare for future epidemics.”