The image of intrepid doctors trudging miles in dirty floodwaters to get to their patients in Houston’s disaster zone gets a lot of attention, and deservedly so. A less dramatic but necessary role is played by health insurers helping members get care in unusual and trying circumstances in all the Southern states affected by Hurricanes Harvey and Irma.
Health plans operating in Harvey’s aftermath said they responded by making it easier to see an out-of-network doctor, get a new copy of an insurance card, or replace lost prescriptions. Insurers set up telephone help lines and eased specialist referrals.
Some of that response was prompted by a Texas Department of Insurance request that insurers “do the right thing” by suspending some of the restrictions that could hamper members’ ability to get care, and have it paid for, when they have lost key documents or are living in a new area. These include waiving penalties on out-of-network care, extending filing deadlines, offering 90-day prescriptions, and paying providers promptly.
The biggest health insurer in the state, Blue Cross Blue Shield of Texas, with 1.5 million members affected by the storm, said it would comply with the department’s request. The company has assigned a team to not just answer member questions but to call some of them to offer help with emergency resources. Patient clinical summaries available on its patient and provider portals helped members explain their medical history to a new doctor.
Humana officials said they had staff reaching out by phone or email to more than 300,000 members who are identified as being in Harvey’s path, with more than 242,500 phone calls already placed checking on member welfare. More than 3,000 Humana employees work in the affected region, with 800 of them dealing with the potential of flooding; supervisors checked on them and offered help, said a Humana media relations manager.
In Florida, insurance officials asked health plans to make it easier for members to get prescriptions ahead of the storm, anticipating logistical problems afterward. Many of Florida’s major health insurers said they were loosening the rules for members after Irma, and many were making significant cash contributions to recovery funds.
Preparedness metrics needed
A 2013 survey of health insurers by America’s Health Insurance Plans found that 85% maintain emergency teams, 59% have physical emergency operations centers, and 40% have an emergency call center. Most (71%) said they are prepared to temporarily suspend prior authorization rules.
The survey found less preparedness in health plans’ connections with emergency planning officials, with several plans indicating challenges in knowing whom to contact in case of a disaster or public health emergency. Just 30% of plans participated in preparedness drills with external stakeholders, though most said they are interested in doing so.
Researchers looking at the AHIP data found some areas for improvement in disaster planning, noting that a minority of insurers in the survey were using specific metrics to assess their emergency preparedness efforts, such as percent of critical systems tested. They suggested the industry develop measures, perhaps borrowing from other industries and tailoring them to health insurance’s unique challenges.
The researchers also recommended better connections between health plans and local health officials, and urged insurers to become involved with local and regional coalitions of health care organizations that maintain relationships so they can share information and resources in an emergency.