Industry News

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

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, challenges and key lessons, SmartBrief spoke with WPS Health Insurance Executive Vice President Jim Baird about how his company is dealing with and adapting to these challenges.


Jim Baird

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

It is a challenge to balance planning for future claims increases with the need to support members in as many ways as possible now.  We have to consider the impact of delayed medical care, the cost of a vaccine and coverage of universal testing, along with other uncertainties.

Moving to an over 90% remote workforce in a very short time and then maintaining it over several months was also challenging. It went more smoothly than anticipated, but we continue to support working parents with children at home with the likely prospect of school being virtual again in the fall.

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

Agility was a crucial element in successfully navigating the ever-changing environment during the pandemic. Whether it was to implement government requirements or respond to customer needs as new information was received about health care, unemployment, the spread of the virus, etc., the ability to pivot quickly was essential.

Customer and employee care has been a priority. Being flexible and proactive to meet needs and provide support in a variety of ways was very important as both groups faced challenges they hadn’t seen before. As a result, we saw our employee engagement and net promoter scores actually increase during the pandemic.

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?

Because in-person medical services were largely shut down, we made the decision to cover telehealth services without any out-of-pocket costs to our members through the end of the year, both through Teladoc and local providers. We saw utilization of telemedicine services increase more than tenfold following this decision. The hope is that providing a way to get care when it was needed, rather than postponing it, will lead to better health outcomes later by preventing conditions from worsening.

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?

Some key changes will be:

  • Continued higher utilization of telemedicine.
  • A high percentage of the workforce remaining remote.
  • Greater emphasis on preventive education and outreach.
  • Better use of data analytics to predict trends and outcomes.

Jim Baird is a 30-year veteran of WPS, with a successful record of taking on various leadership roles. He was promoted to executive vice president of WPS Health Insurance in March 2018. In January 2020, he was given additional responsibility for EPIC/WPS Health Plan Specialty Benefits.