8 Ways Payers Can Support Provider Partners During Coronavirus
By supporting providers in these eight ways, payers can meet their provider partners’ financial, professional, and personal needs during coronavirus.
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- In the face of coronavirus, payers have a unique opportunity to show their support for provider networks in a tangible way.
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Payers and providers historically have struggled to trust one another. Often the entities find themselves at odds regarding reimbursement and cost of care.
The coronavirus pandemic broke out at a time when the payer-provider relationship was experiencing major change: payers and providers were trying to reform their relationship for the sake of pursuing value-based care.
By being transparent with data, aligning incentives, and being open to provider input, payers began building better trust with their provider partners. Coronavirus interrupted and could have threatened that progress.
READ MORE: Providers Report Low Levels of Trust in Healthcare Payers
However, payers are proving that coronavirus does not have to sabotage those efforts at building trust. Instead, they are finding more tangible ways to continue proving their support for their provider networks.
Supporting independent providers financially
Independent providers are struggling with their own challenges right now, apart from the difficulties faced by their hospital and employed counterparts.
Vanessa Guzman, associate vice president of Montefiore Health System, made this distinction in a recent Healthcare Strategies episode. Montefiore has a mix of providers that are employed by Montefiore and those that are “voluntary” or independent practitioners.
“The priorities are different for each,” Guzman explained. “For those that are non-employed, that are community-based, they’re running a business. So their overhead is a bit different than someone who’s salaried.”
Payers are offering opportunities and financial support to help independent providers in these tough situations.
READ MORE: Role of Market Share In Payer-Provider Reimbursement Negotiations
Centene recently launched a grant-writing and small business program to help providers secure financial support and small business loans through the CARES Act. The program has its own online portal to help providers spend less time researching grants and also gives them access to experts who will assist them during the application process.
Other payers are giving more direct economic support.
Delta Dental, for example, committed $200 million in loans to its independent provider network. The loan network includes interest subsidies, principal deferment, and refinancing options.
Speeding up reimbursements and adjusting payment structures
In light of the severe economic toll that coronavirus is already inflicting, payers are setting up new payment structures to speed up reimbursement.
Both public and private payers have adopted an advance claims reimbursement strategy. Medicare, Blue Shield of California, and UnitedHealth Group have all announced ways to speedily get reimbursements to providers.
READ MORE: Payers, Providers Under Fiscal Strain Rally To Combat COVID-19
Blue Shield California is offering financing guarantees and allowing providers to revisit their contracts and make adjustments, committing $200 million to these efforts.
UnitedHealth Group announced $2 billion in claims reimbursement and financial support for its commercial, Medicare Advantage, and Medicaid businesses. The payer is also dedicating up to $125 million to small business loans for OptumHealth providers.
Making telehealth more accessible
Healthcare delivery is changing, shifting into an almost strictly digital context for non-urgent care. Telehealth is now not just a convenience, but a necessity.
For certain providers who may not have acquired a telehealth platform, CareFirst Blue Cross Blue Shield (CareFirst) in Maryland is offering access to a platform called DrFirst’s Backline Telehealth through the end of the year.
Maryland State Medical Society (MedChi) independent providers with five members or less were able to enroll in DrFirst’s Backline Telehealth for free from March 1 to April 17, 2020.
Through this model, CareFirst’s patients get access to telehealth and their provider partners can maintain business.
Educating nurses about coronavirus
Coronavirus misinformation is rampant, particularly due to the many unknowns still associated with this disease paired with public panic.
However, with the fluctuations in our understanding of COVID-19 and with constant regulatory changes and statewide responses, providers can also find themselves in the dark.
Kaiser Permanente has partnered with Futuro Health, the Service Employees International Union-United Healthcare Workers West (SEIU-UHW), Pima Medical Institute, and The Education Fund to educate nurses about the coronavirus pandemic. Licensed vocational nurses in California have access to this online resource for free through Futuro Health.
The online course, called “Pandemic Readiness for LVN/LPNs,” went live online on April 6, 2020. It is five chapters long and takes six hours to finish.
Providing childcare for healthcare workers
Many frontline healthcare providers have to take extreme measures—including potentially quarantine themselves in a separate living space—to ensure that they do not spread the coronavirus to their spouses, children, and other at-risk family members.
On top of an already tenuous predicament, many states have closed schools for the year, leaving healthcare workers to juggle their intense schedules, mitigate the risk of spreading coronavirus to their families, and find a way to care for their children during their work hours.
In light of this, public payers have moved to cover childcare services for healthcare parents. States—including Arizona, California, Georgia, and Massachusetts—have provided funding for healthcare workers to cover childcare needs or are offering priority access to childcare for healthcare professionals.
State payers have been more quick to cover childcare services for healthcare providers than private insurers have. Blue Cross Blue Shield of Texas is among the few private payers that have announced providing funds for childcare services, as part of its $1 million donation to the Communities Foundation of Texas.
Providing personal protective equipment
One of the most obvious ways that payers can support providers at the moment is meeting their physical needs.
Frontline workers are exposed to coronavirus on a daily basis. Supply shortages jeopardize a provider’s ability to access personal protective equipment (PPE) such as masks and full body suits which can prevent healthcare workers from contracting COVID-19.
In response, Blue Cross Blue Shield of Texas (BCBSTX) donated $1 million to Communities Foundation of Texas, the largest Texan community foundation encompassing 30 community foundations. The funds will go in part towards providing personal protective equipment to first responders.
Meeting providers’ physical needs
Perhaps just as important as protecting providers from the virus, however, is the task of maintaining their physical strength. With long hours and little time to care for themselves, providers do not always have access or time to prepare quality foods to restore their energy.
Some payers have focused on this need by funding organizations that serve food to healthcare workers.
Blue Cross Blue Shield of Massachusetts (Blue Cross) announced it is giving $550,000 to nonprofits serving healthcare workers, as well as first responders and retail workers, to be distributed partly in the spring and partly in the fall of 2020. The funds will go toward food and other basic needs.
Staying out of the way when necessary
Sometimes the best way that a payer can support its provider partners is by taking itself out of the equation somewhat.
Many payers are doing this by relieving administrative burden, such as waiving prior authorization requirements.
Kurt Herzer, head of population health at Oscar Health, underscored that payers should know their providers’ strengths and help providers leverage those specialties.
“Let docs be docs,” Herzer said in a recent Healthcare Strategies episode. “They trained for moments just like this. They know how to handle situations like this. Us not trying to overly insert ourselves at the wrong junctures is actually also important. The goal is never to supplant what providers in the network are doing, but to augment what they're doing and to make it easier for them to do their jobs.”
For the payer community, value-based care means caring for both patients and provider partners. In the heat of the coronavirus pandemic, payers across the nation are stepping up to reinforce the relationships that value-based care has been reforming.
