Industry News

Navigating COVID-19 in the health insurance industry: The view from Priority Health

The COVID-19 pandemic has created a variety of challenges for payers, their employees and their members. It has required the health care industry to reach members and patients through different channels, providing answers and reassurance, and providing care in new ways. To learn more about the impact, SmartBrief spoke with Marti Lolli chief marketing officer and senior vice president of consumer and government markets at Priority Health about how her company is managing the challenges of this time. 

Lolli
Marti Lolli

What has been most challenging for your company and members during the pandemic?

One of the greatest challenges has been the uncertainty that it has created. We do pandemic modeling as a normal part of our enterprise risk management process, so we may have been better prepared than others. However, the situation continues to evolve with no clear end in sight, which requires constant reforecasting and continuous innovation. Our mission is our north star and we rely on it to guide our decisions:  improve health, inspire hope and save lives. This work was more critical then ever and even more relevant. 

And so, our top priority is always to make sure that our members have access to the care they need, but the pandemic forced hospitals to cancel non-emergency procedures and many members postponed care. We are working closely with our members to help them navigate their needs and access care in new ways. We are also working with the provider community to understand what they are experiencing and how we can best partner.

What have been the most important lessons, and how has your leadership navigated them?

Communicate, communicate, communicate. Early on we realized that while there are many crucial aspects to making a functional, safe and supportive work environment during this crisis, effective and frequent communication with all of our audiences is critical to allowing us to continue to operate quickly, safely and intelligently. We have also been reminded about the importance of being flexible. By being nimble we can be better prepared to pivot as needed to deal with new challenges as they happen.

Our communications are frequent and comprehensive with all our audiences, including recurring virtual town hall meetings with our own employees. Individuals and teams need to know we’re here for them and even though we’re apart we’re still working together.

We learned how fast we could move and make decisions.  Decisions about covering testing and treatment had to be made in days, not weeks.  We were first to market with many key decisions before many health plans and actively supporting the tough decisions our state policy makers were making. 

Health plans did a lot to support members and health care providers as the scope of the pandemic became clear. What was the biggest change you made, and what was the impact?

At Priority Health we have some of the lowest administrative rates in the country which means we can spend more on member care. This focus on efficiency helped make it possible for us to be one of the first insurance plans in the nation to provide premium credits to small group and individual members in the Affordable Care Act market.  Priority Health plans to return any revenue above the company’s low administrative rates back to employers and members.

One consistent area of focus has been finding ways to reduce costs and relieve the financial burden for members and providers. We want to ensure people have access to affordable care and coverage.

When Michiganders moved from the workplace to in-home quarantine, employment statuses changed, and income became uncertain for many. In response, Priority Health adjusted premium deadlines, and waived cost sharing for many important services and benefits. We are offering $0 testing and treatment for COVID-19, $0 virtual care for all members and $0 in-person primary care visits for Medicare Advantage members.

We have also done a lot of work with providers including extending program deadlines and streamlining our authorization processes. We accelerated value-based payments and quality bonuses paid through our PIP program and increased payouts on telehealth services to help providers remain financially strong.

It seems clear that this industry will never be the same. Could you describe what you see as the new normal for the health care experience?

One thing we know for certain is that this situation has shined a bright light on the benefits of a digital-first approach and driving to greater personalization based on predictive analytics.  

Greater adoption of virtual care is a good example of how members have embraced digital solutions. A recent report by the American Medical Association shows physicians and other health professionals are now seeing as much as 175 times the number of patients via telehealth than they did before the pandemic. Priority Health has heard from many members who have used virtual visits for the first time during the pandemic. They have appreciated the simplicity and convenience it provides. By offering $0 cost share virtual visits through the end of 2020, Priority Health seeks to not only ensure that high-risk members have affordable access to care, but also help enable the transformation to more virtual health care services in the future.

The other area we see as a new normal is providing personalized recommendations to our members based on predictive analytics and machine learning. For example, we sent custom messaging to 47,000-plus members identified as most vulnerable to contract COVID-19. The data-driven approach enabled our registered nurse care managers and concierge services to deliver personalized communications and support — making sure members had access to their medications, virtual care and someone to check in and ask how they’re doing.

Marti Lolli is chief marketing officer and senior vice president of consumer and government markets at Priority Health, a nationally recognized health plan. She oversees the individual market, Medicare advantage and Medicaid markets, the wellness department, customer experience, market intelligence and the South East Michigan leadership. She also oversees strategy for all marketing capabilities, including brand and member engagement, public relations, social media, digital and corporate communications at Priority Health.