America’s vaccine rollout is underway and while it is beginning to pick up steam, there were and continue to be missteps, miscommunications and failures are everywhere you look. The CDC reported in February that only half the doses shipped to states have been administered. Pregnant women have received conflicting advice on getting vaccinated. And Black and Latinx Americans “are falling behind in the nationwide race to get vaccinated against Covid-19,” according to Politico.
These have mostly been treated as logistical problems, but it would be more accurate to call them communication failures. Vaccination information so far has been disorganized, erratic and shrouded in confusion. To find out when and where to get vaccinated, do you go to your local health department’s website? Your pharmacy’s website? Your provider’s website?
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Mark Poling Mark Poling is Chief Product Officer at Zipari, where he develops innovative technology platforms to improve the health-insurance customer experience.
Each of those places has vaccine information, to be sure. But none of it is complete or easy to understand. None can tell any individual exactly where they stand in the vaccination hierarchy, when they’ll be eligible for the vaccine and where they should go to get it.
Health plans could provide all of that information. They have the health records, demographic information and in most cases the employment information needed to determine when each of their members’ will be vaccine-eligible. They have the credibility to educate their members on vaccine safety. They could easily collect and curate public-health information to tell members when, where and how to get vaccinated as soon as they’re eligible.
In our work with health plans, I have heard the latest Covid-19 outbreak, and the year ahead, compared to a hurricane. We know it’s coming, but we can only guess what its path will be, whether it will be a Category 2 or a Category 5. But unlike a natural disaster, which is largely out of our control, the insurance industry can do more than forecast the damage from the pandemic. We can help mitigate it – and save millions of lives.
How health plans can take the lead
In a sea of conflicting information and shifting guidelines, health plans’ most important function is getting their customers the right vaccine information, at the right time, through the right channel. That means sending alerts when it’s their turn in line and making sure they have the knowledge and resources to navigate the system from there.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Health plans have access to all the necessary information, from age brackets to employer categories to health conditions that impact vaccine eligibility. They know their members’ addresses, phone numbers and email. As vaccines become available to people over 65 or people with certain health conditions, health payers are in a unique position to communicate with those groups rapidly and at scale.
Ideally, it would look something like this: Health plans rapidly ingest the latest guidance on eligibility, access and vaccination locations – by scraping the website of the local health department or whatever official source has that information – and feed it into a database that also contains their members’ ages, employers, health histories and other factors.
Every time a member becomes eligible, the system immediately informs them — through email, text, phone or push notification from a mobile app, depending on each member’s preference and their past behavior. Communications also go out to their primary care providers and employers to maximize the likelihood of reaching the member and getting them to a vaccination site.
This communication needs to be accompanied or even preceded by guidance and advice on navigating the vaccination system. The vaccine rollout so far has been rife with stories of people realizing they are eligible only to be stuck in never-ending phone queues trying to schedule an appointment or getting a first dose and then being unable to schedule a second.
All systems go
The problem, of course, is that most health plans don’t have the technology to do what I just described. They have all that information about their members, but it’s often housed in disparate databases that don’t communicate with each other. Their call-center reps often have to jump between two or three different computer screens to answer member questions about simple things like coverage levels or provider networks.
There are health plans that still require their members to fill out paper forms just to change their address. How can we expect them to communicate accurate, real-time information on vaccines? Especially since the U.S. vaccine rollout is only going to get more complicated as more of the population becomes eligible.
But payers can certainly empower customers to make quicker and more informed decisions, and point them to available resources from providers and health agencies. And they should do exactly that – for the health of their members, their communities and their own bottom lines.
Payers that don’t have the member experience technology to determine eligibility and automate communications should still use whatever communication avenues they have to help customers navigate this once-in-a-lifetime challenge. Every payer could sort through public information on vaccine procedures and send regular email updates that translate that information in ways their members can understand.
These next few months are a tremendous opportunity to build trust with customers — imagine the reciprocal goodwill if a payer’s message helps its members get to the front of the line.
Beyond the fight against Covid-19, the past year should also serve as a call to arms for digital integration across the healthcare space. For insurers still operating with legacy systems in which billing data is siloed from medical data, this crisis should spur action — and investment.
Health plans may not be able to implement new technology systems in time to help with the vaccination effort, but the imperative for agile and targeted member engagement is impossible to ignore.
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Mark Poling is Chief Product Officer at Zipari, where he develops innovative technology platforms to improve the health-insurance customer experience.
