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Opinion: 5 Ways MCOs Can Address COVID-19 Transmission

MHE PublicationMHE August 2020
Volume 30
Issue 8

Principals of DeltaSigma, LLC , Don Hall, M.P.H., and Sherry Rohlfing provide Managed Healthcare Executive an opinion piece on how managed care organizations can address COVID-19 transmission.

As we all now know, SARS-CoV-2is an extremely communicable, novel virus with the potential for death and long-term disability that’s spread through respiratory droplets. Wearing suitably protective masks and social distancing are critical to stopping its spread. Yet a significant number of Americans refuse to wear a mask, guaranteeing the pandemic will rage on.

For managed healthcare executives, the lack of mask wearing isn’t surprising because they know how difficult it is to engage people with their own health and well-being. Those of us who work in healthcare sometimes lose track of the fact that health and healthcare are on a long list of concerns that people have: personal finances, housing, work, children, aging parents and even food — people live complicated lives. There are also those who cope with health problems by denying them.

But for health plans, getting people to care about — and be involved in — their healthcare is critical to their improved health outcomes. And for high-risk members, engagement can be a lifesaver, literally.

lndeed, care and disease management programs are a core competency critical to a health plan’s success, starting with health risk appraisals, and then identifying high-risk members and engaging them in appropriate care-focused activities.

If we’re fortunate, a COVID-19 vaccine will become available fairly soon. Still, healthcare executives must view this disease as a long-term issue. Many of them have knowledge and experience with managed care techniques that could be helpful as the pandemic drags on, such as:

  • Stratification methodologies for member risk levels based on demographics, social determinants of health and health status.
  • Engagement strategies that improve compliance with current guidelines from the CDC and include information on staying safe, early identification of symptoms, and minimizing the risk of transmission.
  • Home care services for members with chronic conditions or COVID-19 to keep them away from hospitals, clinics and long-term care facilities where transmission could be especially harmful.
  • Guidelines for mask usage and distribution of free reusable masks with easy-to-understand instructions on their use and cleaning.
  • Public health messaging about the seriousness of COVID-19 and reinforcing the steps necessary to reduce exposure and

COVID-19 is now woven into the fabric of our lives, yet the consequences are unpredictable. Managed care organizations can help by stepping up and bringing to bear the expertise they have in dealing with members with chronic illness and applying it to COVID-19 care.

Hope resides in the short- and medium-term responses to the epidemic, especially in the progress being made toward the development ofa vaccine. Clinicians and researchers are also making headway in the treatment of the disease. But there’s a long haul ahead, and for that we’ll need planning, implementation of those plans, an abiding sense of purpose — and each other.

Don Hall, M.P.H., and Sherry Rohlfing are principals of DeltaSigma, LLC, a consulting firm that specializes in strategic problem solving for managed care organizations.

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