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Meeting the challenges of COVID-19: Health insurance industry leaders outline pandemic priorities

A conversation with health insurance industry execs

6 min read


Meeting the challenges of COVID-19: Health insurance industry leaders outline pandemic priorities

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While people around the world watch COVID-19 news wondering when life will return to normal, health insurance executives are acutely aware that the effects of the pandemic will be felt for years to come, and that some challenges may become more difficult before we see relief.

A recent Salesforce roundtable with leaders from the health insurance industry shed light on the most pressing issues health insurers are dealing with as the crisis continues. Top of mind are:

  • Addressing social determinants of health (SDOH) during and after the worst of the pandemic
  • Reimagining health insurance company staffing, processes and support in the new normal
  • Meeting post-pandemic expectations for customer experience

SDOH amid a global crisis

One of the most important tasks for health insurance providers during the pandemic has been continuing assistance for their most vulnerable members. Social determinants of health have only been exacerbated by the pandemic and are affecting more people than ever. For example, the number of laid-off workers in the US recently hit 1.1 million following two weeks of declines, and the CDC found in late June that more than 40% of US adults are experiencing worsened mental health conditions associated with the pandemic.

Complicating matters is the fact that plans can’t provide SDOH interventions in the same way they historically have. These interventions have often occurred heavily in person, and while the pandemic has augmented the need for SDOH interventions, it has created new challenges for their delivery.

In many cases, health plans have partnered with nonprofits, but quickly standing up and maintaining those partnerships has been challenging, as food banks and other local partners themselves have struggled and sometimes closed during the pandemic.

Despite the challenges, plans embracing proactive outreach to connect with members and ensure they are aware of the options and services that are available – and the new virtual ways in which they can be accessed. These efforts include:

  • Engaging customer service representatives and sales reps to check in with seniors as part of a loneliness alleviation program 
  • Using analytics to guide an outreach campaign for at-risk members to discuss their needs and coordinate services
  • Offering online events such as Zumba classes for seniors and virtual baby showers for high-risk mothers in low-income areas 
  • Conducting proactive outreach to small employer groups in struggling industries, such as entertainment and hospitality, and transitioning members to a more feasible payment plan or helping them pivot to Medicaid to ensure continuity of care
  • Shipping prescription drugs and meal kits to members who need them

Some of the biggest challenges were seen with the discontinuation of in-person plan services. For example, some plans had to close neighborhood centers in accordance with social distancing, leaving seniors and other vulnerable members without exercise classes and less engaged in their care.

Although they have quickly launched virtual programs to compensate, some insurers aren’t seeing the same effectiveness with this virtual outreach compared with in-person services, especially among elderly, sick and low-income members. Virtual services are not always the right fit for this population, and a recent study in JAMA found that over a third of adults older than 65 weren’t ready for telemedicine visits. With this in mind, insurers will need to determine the best way to serve these populations while maintaining physical distancing.

Returning to work, safely

At the same time as they work to support members, health insurance providers are grappling with next steps for their own employees who were rapidly transitioned to remote settings as the pandemic set in. They must now determine whether and how to bring their own employees back to work with the proper COVID-19 screening, as well as logistical and psychological support.

Meanwhile, internal surveys show that many health insurance employees reported increased satisfaction while working from home, prompting insurers to rethink the composition of their on-site workforce. Continued workplace flexibility after we emerge from this crisis could enable increased employee satisfaction while also lowering overhead costs and freeing up cash for more innovative member offerings.

As executives think through these questions, specific considerations include:

  • Supporting employees who prefer to be in the office or need access to office equipment for certain tasks, such as printing and faxing
  • Allowing flexibility for home-based employees whose children are attending school remotely
  • Ensuring employees both at-home and in-office can come together for the kind of brainstorming and spontaneous discussion that can drive strategic innovation. 

Several also saw technological issues arise from the fact that IT staff, data centers and processing centers are often located offshore in India or the Philippines, and employees working from home in those regions may have access to different infrastructure for phone calls and online work than they did in the office.

While these issues and others will need to be addressed over time, plan executives noted a variety of tools helped ease the transition to remote work, and those tools can continually be leveraged to keep remote colleagues connected with those who return to offices. These include virtual white boards for brainstorming sessions, lunches or coffee sessions over Zoom and occasional virtual happy hours to encourage an early end to the workday, giving employees time to connect and rejuvenate.

The post-pandemic customer experience

Finally, insurers are embracing their role as a definitive source of public health information, and they are meeting heightened member expectations for personalized, accessible and multichannel support.

Members are looking to insurers for reliable, fact-based information about COVID-19 prevention, risk and how to safely obtain care in an environment that is rife with mixed messages, confusion and misinformation. Insurers sought to meet this need in myriad ways, such as rapidly creating self-serve digital resources with clear, concise information.

One plan quickly began offering town halls for members on Facebook in both English and Spanish to respond to basic questions about the virus, such as whether it was safe to open their mail. Others found themselves reassuring members that it was still safe to handle their groceries.

Members and group customers are also looking to health plans for expertise on returning to the office. Plans are providing information to members and making these decisions for their own organizations, while recognizing that there will likely be additional waves of infection in the future, particularly once flu season hits, as well as more sustained heart or other organ injury from COVID-19 for some.

It is clear that as we move into the next phase of the pandemic and beyond, insurers will need to position themselves as an authoritative, digitally accessible source of basic information and as myth-busters as they guide their members through unprecedented confusion, fear and conflicting messages.

Insurers that embrace their role as a trustworthy public health resource for members during this confusing time and meet their customers where they are, have the opportunity to redefine the role of a health insurer and position themselves as partners in both their members’ health and lives.

SmartBrief will be taking a closer look at these issues and more in an upcoming content series based on insights gleaned from health insurance executives at a recent Salesforce roundtable. For more resources on member experience, remote work and member engagement, please visit the Salesforce content hub.