At DataOceans, we are fortunate to count several executive thought leaders among the members of our advisory board. In this blog post we feature an interview with Joseph Smith, a board member with extensive experience in the healthcare industry.
DataOceans: We’re approaching the first year of grappling with Covid-19, and by the looks of it we’ll still be talking about it into late 2021. On a scale of 1 to 5 (with 1 being complete failure and 5 unmitigated success) how have health insurers been doing on communicating to their members about the virus and the vaccine?
Joseph Smith: A “2”. Health insurers have encountered a huge challenge in a couple of dimensions in trying to deal with communications. Two of the most formidable challenges have been:
- COVID 19 is a very new virus, never seen before, and therefore health insurers, like everyone else, was at “Ground Zero” on knowledge of the infection, its array of implications and additional health maladies that it creates, let alone how to treat it and how to prevent it with a vaccine.
- Mixed medical messaging (sometimes even conflicting) being issued at the federal and state levels, as well as the multitude of state level variations in lockdowns/testing protocols and availability, provider access limitations, etc. have been very difficult for a health insurer to formulate an effective communication message… and … to keep it up to date, as medical knowledge, therapeutics and vaccine developments have evolved.
DO: Communicating about the virus has been difficult, especially given the fact that a not insignificant percentage (as much as 40%) of the population does not believe that the virus poses a serious threat. How can providers and payors rebuild trust with this group?
JS: Health plans should consider taking the high road on this issue and continue to provide honest and scientific-based health education to their customer base.
DO: The government has temporarily mandated changes like telehealth services, expedited authorizations and short-term prescription refills. Will any of these (or other changes) become permanent going forward?
JS: This past year, with its many tragic events and implications, has been a very positive evolution force to accelerate the adoption of many tele-health capabilities, which have heretofore been sluggish due to adoption incentive (not the technology available) to support these capabilities. Telehealth services are here to stay and will grow in use and value to the access of care, particularly in rural America. Pre-authorization process acceleration is now a mandated rule for health plans and providers to initiate changes in today’s slower progress. This will be done within the strategic scope of the “Interoperability” regulations issued in 2020. Our journey toward the “Holy Grail” of secured electronic exchange of healthcare administrative, clinical and financial activity is going to accelerate!
DO: What are some of the takeaways from this crisis that can help organizations deal with future crises?
JS: One: Keep your organizational focus on following the evolution of medical and technology science. Two: Communicate with your audiences with polite candor, with supporting science based rational, and sensitize the audience to expect evolution of medical evidence and defensive techniques evolve.
DO: An estimated 10% of Covid patients are so-called “long haulers” who are sick for months after initial treatment. This could mean as many as 50,000 or more chronically ill patients. And many of these patients may have never actually received a Covid diagnosis. How do healthcare organizations approach the needs of this new population?
JS: Health Plans should consider creating a special sub-unit of their Care Management Operations to focus on this critical care subset of their enrolled population, who will unfortunately encounter severe and complex medical conditions going forward.
DO: Are you optimistic about how the vaccine rollout is progressing? What could healthcare payors or providers do to improve on it?
JS: While very disappointed at the pace of the vaccine rollout, we need to keep overall perspective of the “medical miracles” that have emerged through the intense research and development of many vaccines that are emerging worldwide, in such short order. This very rapid availability of proven vaccines, particularly those based on new genetic engineering techniques, will also have a very positive spin-off effect on treatments of many other medical maladies. A totally “New Age” of genetically engineered treatments will be emerging, now that we have some real-life visibility into the speed and accuracy (e.g., very high effectiveness rates) of these new techniques.
DO: What are some other challenges in healthcare that providers and payors are facing in 2021? What other issues are we missing due to the focus on Covid?
JS: Watching closely the evolution of COVID new strains, and rapid conduct of research on the effectiveness of existing therapeutics and vaccines, will be critical to help close down the adverse infections globally. COVID’s impact on the gradual adoption of PFP and bundled payments will be slowed somewhat as the levels of complexities and combinations of medical maladies drive many variations in what would typically be more narrow treatment protocols (i.e., far less standardization of any current medical treatment protocols that now have a COVID ingredient).
Much more intense focus on medical supplies and equipment and capacity planning and management will be demanded, to avert the serious shortages that quickly emerged in early 2020. This may well even open up new collective/shared Supply Chain Management firms and partnerships to support this huge new need.
DataOceans advisory board member and healthcare executive Joseph Smith has spent many years in healthcare and IT leadership, most recently serving as Senior Vice President and CIO at Arkansas Blue Cross and Blue Shield. He has served in numerous healthcare and technology committees and strategy organizations and testified on legislative matters before several Congressional committees.