MCOs share lessons learned from Harvey: 5 things to know

Even before Hurricane Harvey made landfall in Texas, health insurers were prepared for the worst. Here, they discuss what steps they took before the storm hit.

1. Have a disaster preparedness plan in place for area employees.

Ross McLerran, spokesperson, Humana, West Region (based in San Antonio, Texas), says the company has an emergency response plan in place. “Every new Humana employee enrolls in an emergency preparedness training course,” he says. “This training helps associates prepare for an emergency at work, such as a fire, severe weather, medical emergency, workplace violence, and shelter-in-place events, as well as others, and provides a basic understanding of how to respond and what to do to keep themselves and fellow employees safe.”

Each year before hurricane season starts, the plan is reviewed, updated, and distributed to those involved in storm preparation and recovery. Hurricane drills are conducted to ensure coordination between departments as they implement the plan.

“Conducting contingency planning exercises to ensure your core functions have back-up plans is key,” says Nike Otuyelu, compliance and risk management officer, Community Health Choice, Houston, Texas. “Share concerns, recommendations, and needs with vendors and partners before an emergency situation so you are as prepared as possible. Then, during the emergency maintain robust communication between leadership, employees, and members. Coordinated teamwork is crucial.”

2. Let members know how you can help.

Humana members were notified that its free crisis intervention hotline was available 24/7 to them as well as all residents within the storm’s path, including those who were not Humana members.

Humana also notified members via e-mail that customer service was available to connect enrollees with physicians and specialists if care was needed, and also assist with refilling prescription medications, replacing durable medical equipment and medical supplies, and replacing member identification cards.

Next: Tips three and four

3. Contact members with special needs.

Before Hurricane Harvey hit, Mary Dale Peterson, MD, MSHCA, FACE, president and CEO, Driscoll Health Plan, and vice president of Driscoll Children’s Health System, Corpus Christi, Texas, says they developed a list of high needs members, especially those who were technology dependent such as having continuous feedings, ventilators, and suction equipment. “We encouraged these individuals to register with the 211 system, which can aid in evacuation and emergency response,” she says.

Staff personally called all 468 members with high medical needs and those who were technology dependent when the tropical wave was in the Gulf of Mexico to remind them to start preparing, such as getting prescriptions filled. They also called 110 of those members who would likely be directly affected by the storm 24 hours prior to landfall, encouraging them to evacuate to areas that would be less affected by power outages and flooding. They assisted with evacuating members, especially those who hadn’t signed up with the 211 system. For example, they arranged for transfer to hospitals outside of areas that were projected to be affected. These were members requiring 12- to 24-hour private duty nursing who were ventilator dependent. It also helped members who were not technology dependent with resources, such as where to find buses and shelters.

Daisy Morales, vice president, Community Affairs, Community Health Choice, says social media and the health insurer’s website became key avenues for disseminating timely information and resources. Staff made proactive outbound calls to help its most vulnerable members with prescriptions, medical care, and other urgent needs while displaced from their homes.

4. Waive certain requirements.

Driscoll Health Plan lifted all prior authorization requirements, including its out of network and too-soon-to-refill pharmacy edits. As a regional plan covering The Children's Health Insurance Program (CHIP) and Medicaid in South Texas, other than pharmacy, it doesn’t have networks in other parts of Texas. Therefore, it worked with other regional plans to access their providers and health services staff to ensure members received care in their evacuated locations.

For Community Health Choice members, pre-authorization waivers were implemented, and the organization prioritized prescription reminders and refills, and called displaced and vulnerable members to help make sure their health needs were understood by out of town providers. Providers were given additional time to submit claims.

“We coordinated with vendors and partners, such as telemedicine vendor Teledoc, which waived copays or coinsurance to make sure displaced persons got the care they needed, including oxygen tanks and life-saving medications,” says Karen Hill, MD, senior vice president and chief medical officer, Community Health Choice.

Next: Tip #5

5. Position staff and technology out of harm’s way.

Some key staff were evacuated to satellite offices that would not be affected by the hurricane. Driscoll Health Plan’s data center is completely colocated hundreds of miles away. “We moved our call center systems to other locations and unaffected staff helped cover for staff in the Corpus Christi region who were working on securing their homes and evacuating. “Having some de-centralization was helpful,” Peterson says. “We were able to work remotely throughout the storm to continue business as usual.”

Community Health Choice has a back-up call center in a different city, secure back-up IT and email in a different city, and key employees including member services and medical directors set up to work from home as needed.