As both payers and providers grapple with a new round of COVID-19 stress to the health system due to variants such as Delta and Lambda, health plans face a growing array of challenges requiring rapid and effective response.
- Contact tracing and immunizations have taken on a new level of priority as the Delta variant burns through communities. The risk of additional mutations signals that health care impacts from the pandemic will continue to be front-burner for some time.
- There will be a greater burden of members needing complex care management, both COVID-19 long haulers and people who are skipping screenings, regular care and diet and exercise regimens. The combination is creating a build-up in acuity of chronic conditions that need to be managed and treated.
- Provider networks are in flux, with M&A, new venture- and equity-funded provider companies and solutions and provider fatigue creating new potential network gaps.
As a result, it’s more important than ever for health plans to leverage data to identify and manage cohorts of members. Payers also must focus on network utilization, quality and gaps. And to pave the way forward, they need to model and implement best-practice, value-based payment agreements.
With the major threat of clinician and healthcare workforce burnout, health plans should bring to bear resources and partners to support the stabilization and enhancement of current workforces while developing large pipelines of future workers and providers to ensure adequate capacity.
Our team is ready to help health plans successfully navigate these unique and challenging times.
For information on how COPE Health Solutions can provide rapid and valuable services to health plans during this critical time, please contact us at email@example.com.