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How health insurance companies keep up with disruptions from Covid-19

The health insurance industry has suffered more ups and downs than its share, but not more amid a global pandemic.

As Covid-19 continues to alter our world, the South Florida insurance industry is working to keep up with the changes it brings to better serve its clients.

Experts are beginning to look to the future, hoping to identify the long-term effects the virus could have on the health insurance industry as we know it. But for an industry that is booming with flexibility and predictability, the uncertainty associated with the unexpected increase in Coronavirus transmissions is leaving industry insiders with as many questions as it answers.

Although what lies ahead is still unclear, there are some points on which experts agree: telehealth is here to stay; The financial implications of Covid-19 are unpredictable; Employers will play an integral role in future care more than ever, but they must be prepared for the challenge.

Virtual care a mainstay

With patients actively avoiding doctor's offices unless absolutely necessary, accessing healthcare services remotely has become a boon, allowing people to consult healthcare professionals from home.

Insurance providers have long supported the use of virtual services to access care, but patients have been slow to adopt this approach.

"The technology to deliver care has been around for a while, but Covid may have accelerated its adoption dramatically," said Benny Shaffer, president of Florida Blue Market in South Florida. "I think behavior patterns are going to tell us that hypothetical health may be here to stay."

Schaffer also predicts that providers and patients will reconsider the number of visits required to obtain test results or to refill prescriptions that can be hypothetically handled.

Kristin Brown Diobelda, director of health plans practice at Deloitte Consulting, agrees that doctors, patients and the government are supporting telehealth stronger than ever.

"I think you will see that people realize that it is really comfortable and that they will continue to see their doctor by default, even after [COVID-19] is over," she said.

Ensuring that patients have access to virtual care, without hindrance, is a top priority for insurance providers. Most service providers waived subscriptions for virtual care appointments and provided incentives to encourage members to take advantage of the service.

At Florida Blue, ensuring that virtual services include behavioral health during the coronavirus outbreak has been an important goal.

"As time goes by and you think about the level of stress that people experience, you want to make sure they have access to these options as well," Shaffer said. "We immediately provide free 24/7 counseling to people, whether they are members or not, so they always have someone to call."

We have a long way to go

With Covid-19 cases continuing to rise and a second virus outbreak is likely in the fall, it's hard to imagine the financial implications the insurance industry will have as a result.

Miami-Dade County has become a global epicenter for the Covid-19 outbreak in recent months, and Florida has reported more than 440,000 cases in total since March.

"This pandemic has created a whole new world of instability and uncertainty," said Audrey Brown, president and CEO of the Florida Health Plans Association.

Premiums are expected to increase, but it is still too early to tell.

"We are pricing now for 2021 with a really unclear picture of how 2020 will play out," Shaffer said.

The allegations are another aspect of the care that industry experts say has fluctuated as a result of the pandemic.

"One of the positive financial aspects for us is that the healthier you are, the less claims you will have," Shaffer said. "As Covid claims increased, routine care claims decreased."

However, this is not the result of people adopting healthy behaviors. People delay care, except to seek emergency or urgent medical attention, for fear of contracting Covid-19.

"Even if their local hospital opened, they really aren't sure they want to go there because they're not sure they feel comfortable or safe," said Brown Diobelda.

According to Schaffer, many people who avoid treatment for an existing condition (which is not considered an emergency) may be worse off, so requests for routine care are likely to increase soon.

And if the nation experiences a second wave later this year, people may postpone attention again.

Experts note that one of the main side effects of the pandemic is that it has highlighted the need for companies to offer health insurance coverage to their employees.

"Companies that historically weren't required to provide insurance will start to do this," Shaffer said. "You don't want to have employees who can't access care."

Furthermore, he said, those who previously considered themselves healthy enough to avoid insurance now see its value due to unexpected threats like the Coronavirus.

Employers and insurance companies are cooperating

According to Braun DiObilda, employers will play a unique role in the future as they are tasked with knowing how to continue to provide coverage and deciding what to do with health care benefits amid layoffs and cost cuts. For this reason, they are expected to play a much larger role in influencing consumer decisions about obtaining insurance.

Experts suggest that employers partner with their health plans to make decisions about the best way to provide coverage in the most cost-effective way.

Brown Diobelda said many employers have already initiated this communication to create return-to-work strategies, learn how to trace office contacts to alert employees to potential exposure, and understand the potential effects on expected medical costs.

"We are also seeing [employers and health plans] working together to consider what their claims may be and are actually targeting some of their employees to provide services that could benefit them," she said.

Watching employers work side-by-side with health plan and insurance providers has been rewarding for industry experts. They expect this trend to continue long after the pandemic ends.

"As difficult and difficult as this situation is, I have already seen health insurance plans, employers and service providers come together for the benefit of patients," said Brown Diobelda. "This is what we want to keep seeing."