Payers' Moment of Truth is Here


Times of turmoil caused by COVID-19 allow for the formation of deeper relationships with customers, members, and society.

Chris Bernene and Jim Fields

10 min read

Editor’s Note: The following article is part of an ongoing series offering our strategic advice and expertise on what healthcare industry stakeholders should do immediately in response to the rapidly evolving novel coronavirus (COVID-19) pandemic. 

With COVID-19 now officially a pandemic, the first step healthcare payers (and all employers) must take is trifold: ensure business resiliency, establish a crisis response structure, and secure employee safety. Payers will specifically be called on to continue leading the way in supporting the greater public health response.

Overall, the nationwide payer response has been overwhelmingly positive, constructive, and resourceful. Some ways payers are driving change include waiving COVID-19-related out-of-pocket costs, providing customers with reliable and clear health information, and providing their local communities with support resources. Actions like these must remain top priorities in the coming weeks.

In a Time of Crisis, Focus on Customers

From a humanitarian perspective, the COVID-19 pandemic creates an obligation for payers to offer people – customers, members, and the public at large – with information about how to best prepare and respond. From a business perspective, the COVID-19 pandemic creates urgent demand for payers to interact with their members in time of urgent need, in ways that build and reinforce trust.

Times of turmoil often represent important “moments of truth” that allow for the formation of deeper and more meaningful relationships with customers. Consider the many industries whose customer-bases are primarily people experiencing a crisis – like the auto insurance industry which helps people navigate the aftermath of car accidents. These industries are based on helping people act quickly, and on providing responsive services and helping people get back on their feet financially. Consider companies like the United Services Automobile Association (USAA), Progressive, and Geico. They are arguable masters at turning potentially negative situations into positive touchpoints. The result? High customer loyalty and satisfaction.

“One silver lining in the COVID-19 crisis may be members’ willingness to use telehealth services.”

It’s a similar story when you look broadly at property and causality insurers. When these organizations provide exemplary and empathetic service to help customers get back on their feet when a major natural disaster strikes, the organizations tend to see customer affinity spike as a result.

COVID-19 Presents an Opportunity to Strengthen Engagement

Although COVID-19 is obviously a much different crisis than an auto accident or natural disaster, it still creates a similar set of acute customer needs and worries. But it also creates the opportunity to help customers in urgent need. There has already been a first wave of responses from health plans to address immediate group customers’ needs — such as waving prior authorizations, increasing prescription drug access, and offering clinical support services targeted at the highest risk populations. Health plans were working with the US Government to change Internal Revenue Service (IRS) rules to ensure COVID-19 testing could be provided free of charge to members, without interfering with High Deductible Health Plan rules.

Building on these initiatives, health plans should consider actions that allow them to reset customer engagement and relationships over the longer-term. Here are three suggestions:

1. Play a central role in engaging and communicating with the highest risk populations. The elderly and members with chronic conditions are most at-risk. Payers can help these members understand what actions they should take to avoid contracting COVID-19 and what they should do if symptoms emerge.  Some of these members may already be in care management programs offered by insurers. This creates opportunities for enhanced communication and education.  

There is an opportunity to help elderly customers access the health system remotely. According to Oliver Wyman's 2018 Consumer Survey of US Healthcare, "Waiting for Consumers," (conducted before COVID-19) research, although Baby Boomer customers are less likely to have used digital channels (8 percent of Boomers versus 14 percent of Millennials), both groups show similar levels of willingness to try them, and similar levels of satisfaction once they’ve used them.  

“For health plans, COVID-19 is an opportunity to address some of the most critical employer needs in the highest priority segments.” 

2. Expand the number of customers who receive virtual care.Remote and digital care modes —including telehealth — have been on the rise, with more than 88 percent of large employers now offering employees some form of virtual care. Yet, according to our research, only 10 percent of employees have used telehealth to interact remotely with a doctor. We also found that 27 percent are willing to try digital services for routine medical preventative care. 

In fact, one silver lining in the COVID-19 crisis may be the willingness of members to use services like telehealth. It’s likely members are even more receptive in the current pandemic environment. Suppose plans, for instance, put more incentives in place to encourage patients with routine issues to use virtual care services. In the short-term, shifting patents out of facilities will free up precious resources to be on the front-line in treating the sickest COVID-19 patients.

Our data suggest over one-third of customers like virtual services much (or more) than traditional office visits. This suggests that once people try these channels, they’re likely to become repeat users.  

3. Address employer customer needs. As employers continue to respond to this pandemic, some industries have been shaken to their core (like travel, hospitality, and food services). Many employers will have little or no experience with employees working remotely. Expect continued major disruption short-term regarding employee well-being and productivity.

For health plans, COVID-19 is an opportunity to address some of the most critical employer needs in the highest priority segments. For large accounts, what short-term plan design tweaks, service waivers, or enhanced digital tools can help employees remotely manage their health? For smaller employers, could there be special health information resources created for small businesses (many of whom do not have professional Human Resource (HR) management in house) and tips for business resiliency to help them navigate this crisis? Programs and policies that lower exposure risk to employers and employees (such as having employees alternate work weeks onsite and off-site to spread out the office population) might be well known to professional HR leaders in large companies. But this knowledge might not be as prevalent across smaller organizations. 

Be There When Customers Need You Most

Health insurers have long battled a stereotype of not being as customer-friendly as other industries. But a pandemic — even one as painful as this one feels right now — can present an opportunity to show customers, members, and the public at large how much they are valued and how much they are cared for. Taking purposeful steps now, while we are in the early crisis stages, to support customers in “above and beyond” ways will foster lasting rapport. This is the payer world’s chance to demonstrate an empathic approach to customer service today that will reap incredible value tomorrow.