4 Population Health Strategies Payers Use for Back to School
Whether children are going back to school in person or virtually, payers have a role to play in ensuring that they stay healthy by incorporating strong population health strategies.
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- As fall approaches and the coronavirus continues to affect daily life, parents must decide whether and how to send their children back to school and payers must consider population health strategies that support their decisions.
There is not a one-size-fits-all solution to schooling for children at this time. A back-to-school decision making tool from the Centers for Disease Control and Prevention (CDC) with over 30 checkboxes underscores this fact.
Both in-person and online learning can have certain health effects.
For at-risk children or those with family members who are at-risk, in-person schooling could be dangerous, the CDC decision-making tool acknowledged. While children in general seem to be at lower risk of contracting or dying from COVID-19, those with intellectual or developmental disabilities or complex conditions may face severe coronavirus symptoms.
However, lack of in-person schooling can impact children’s mental health, expose them to greater likelihood of domestic abuse, reduce food access for children in food insecure households, and remove structured physical activities, like recess, that protect against chronic conditions.
READ MORE: How Population Health Tactics Fortify COVID-19 Member Engagement
The sheer quantity of social determinants of health that this back to school season affects should motivate payers to get involved.
As parents and schools navigate this process, payers can support whatever decision they make and mitigate social determinants of health barriers with four key population health management actions: expanding broadband internet access, supplying for physical needs and personal protective equipment (PPE), promoting preventive care, and covering school-required coronavirus testing.
Expanding broadband internet access
For children who engage in online schooling and who live in low-income or rural areas, broadband internet access is likely to be limited.
Thus, some payers contribute toward expanding broadband internet access in high-needs areas as a population health management strategy.
For example, BlueCross BlueShield of Tennessee Foundation donated $1 million to the HCS EdConnect initiative. This social determinants of health initiative brings free broadband internet access to 28,500 students in Chattanooga, Tennessee. These children qualify based on their eligibility for free or reduced lunch assistance.
READ MORE: Addressing Social Determinants of Health Requires Population-Based Data
The HCS EdConnect initiative offers these students 100 Mbps internet service, symmetrical internet speed, no data cap, and a WiFi router. Schools will have to pay $2.50 per family per month for the service. The program will raise a total of $8.2 million through its partners to kickstart this initiative.
“We know the COVID-19 pandemic has made learning more difficult for both students and their families, especially those who don’t have fast, reliable internet access,” said Roy Vaughn, executive director of the BlueCross Foundation.
“The HCS EdConnect initiative will help Hamilton County students keep learning in today’s unique environment—and beyond—and help address the societal inequities that make it difficult for families to thrive.”
Supplying for physical needs, PPE
The nature of the coronavirus pandemic has added a new set of supplies to back-to-school backpacks, including masks, hand sanitizers, and other PPE. However, it can be a challenge securing equipment for the vast quantity of people—teachers, children, and staff—who will need these items.
For Highmark Inc. (Highmark), the population health solution was to offer a Back-to-School Toolkit to Highmark-covered school districts in Pennsylvania and Delaware, with plans to expand to prospective school district customers in these states as well as West Virginia.
READ MORE: 6 COVID-19 Social Determinants of Health Payers Pivoted to Meet
The toolkits include face coverings, hand wipes, gallon-sized hand sanitizer pumps, best practice signage, and other resources.
“Schools play a vital role in our communities as they prepare today’s students to become the leaders of tomorrow. At Highmark, we want to show our unwavering support and gratitude for all that they do, especially under the current, ever-changing circumstances,” said Deb Rice-Johnson, president of Highmark.
Promoting preventive care
Immunizations and other preventive care practices that are commonly reinforced through school systems have already suffered dramatically as a result of the stay-at-home orders and pandemic fallout.
From the beginning of the crisis, the CDC emphasized continuing childhood vaccinations as a key aim to support strong population health, whenever possible. The World Health Organization has estimated that these vaccinations prevent two to three million deaths worldwide every year.
In order to protect children from a weak immune system, payers can help inform members about access to free vaccinations and educate members about the need to continue to vaccinate.
“Health insurance providers know vaccines save lives, and are taking steps to increase vaccination rates in both children and adults,” America’s Health Insurance Plans (AHIP) stated in a recent post. “Many vaccinations are available through private health plans with no cost sharing for patients, making it easier for people to be protected.”
Payers are also taking action to support chronic disease prevention through at-home testing kits, with particular attention to diseases that increase coronavirus risk such as colorectal cancer.
Cover school-required coronavirus testing
While certain payers are stepping up to assist in the return to school, some communities have found their payers to be standing in the way of the process, particularly when it comes to school-required coronavirus testing coverage.
In New York, communities and policymakers rebuked payers who only cover coronavirus-testing if it is conducted in response to a specific medical diagnosis.
“School-required diagnostic testing for COVID-19 is considered occupational testing and is not a covered health care benefit,” one of the payers, BlueCross BlueShield of Western New York, explains on its site, directing members to state and local resources instead.
Byron W. Brown, mayor of Buffalo, New York, called on payers to reverse these policies. Asymptomatic individuals will not receive a medical diagnosis for testing and will only know if they are spreaders based on a positive test, he pointed out.
“Any cost savings you may hope to achieve by not covering the costs of testing will therefore be lost when more people are hospitalized as community spread increases,” he argued.
He also stressed that this creates a social determinants of health barrier specifically for communities of color. While the state offers free testing, the sites are not as accessible to communities of color at the community health centers in their regions which rely on payer reimbursements for testing.
“The fact that your companies are ignoring the racial equity dimensions to the decision after a summer of racial unrest is the most distressing consequence of your actions,” Brown charged.
While payers have argued that employers and schools should cover required testing costs, clearly some communities do not share this opinion and in such cases adhering to this policy could further injure member-payer trust, among other serious consequences.
