Payers Double Down On Population Health Programs Amid COVID-19

Among the many initiatives accelerated by the COVID-19 pandemic are efforts to combat inequities in the U.S. healthcare system that have persisted for years but were brought into stark relief when the coronavirus reached the country’s shores.

As a result, payers are implementing new programs to try and improve member health beyond the traditional care pipeline, especially through broader data collections and strategic partnerships, insurer executives said Tuesday at AHIP’s annual conference on Medicare, Medicaid and dual eligibles.

The pandemic created new needs that payers weren’t necessarily yet equipped to provide, according to Julie Weatherly, a program analyst at Pennsylvania-based insurer Independent Blue Cross.

Weatherly said the company discovered many of its Medicare Advantage members were having difficulty ordering groceries online when store shelves at their usual stores were cleaned out of some items. Beneficiaries were having trouble using the apps to select goods and delivery times.

The payer contacted larger companies like Wegman’s and Giant, but their supply chains were too disrupted to be of help. So IBX got in touch with a regional grocer that worked with local farmers and was able to help members get the food and supplies they needed.

That partnership changed some perspectives.

“I think, traditionally, people thought that the only way to partner with a company is if they’re large or if they have experience with Medicare Advantage — all of those kinds of legal and compliance questions we asked vendors before we approach them to do work,” Weatherly said.

Andrew Renda, a VP at Humana who works on population health strategy, echoed the importance of staying local. Humana has more than a dozen population health strategy leads in various markets who liaison with community-based organizations in those areas to determine what methods will work best, he said.

Panelists agreed that the start of a successful social determinants of health program comes with data collection and interpretation.

Renda said creating data ecosystems “becomes foundational for everything else that we do,” and leads to being able to determine the correct, evidence-based interventions.

And any pilot programs should be constructed with scalability in mind, according to the executive.

Humana uses a Centers for Disease Control and Prevention assessment tool that measures the mentally and physically unhealthy days of individuals over a 30-day period as a leading indicator, followed by data on medication adherence and preventive screenings.

“I think one way to look at it is you’ve got to have the right study design to get those requests to justify the bigger investments,” Renda said.

The executives said equity programs can produce ROI, but are often on a different timeline than stakeholders might expect.

It can help to set goals apart from ROI and look at steps along the way to ascertain whether a program is succeeding.

“I think a lot of times some of the social determinants of health interventions take longer to see ROI or outcome than some of our more traditional clinical interventions,” Weatherly said. “So I think for us it’s also level setting with folks who may not have a public health background or social science background.”


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