The leaders of the Eagan-based Blue Cross Blue Shield of Minnesota continue to advance their vision of commitment to the broad needs of their health plan’s members. As part of that commitment, the insurer announced on Feb. 10 that it would extend its coverage for remotely delivered care through the end of the year.
The press release posted by BCBSMN on Feb. 10 began thus: “As part of its ongoing effort to help prevent the spread and impact of COVID-19 and improve the long-term sustainability of health care in Minnesota, Blue Cross and Blue Shield of Minnesota (Blue Cross) today announced extended eligibility for certain expanded benefits. Early in the COVID-19 pandemic, Blue Cross temporarily expanded virtual care benefits for its members to help improve access to health care services while reducing the need for in-person care across various specialties. Blue Cross members have continued to utilize these expanded benefits at a high rate throughout 2020 and into 2021. As a result, all temporary virtual care coverage changes currently in effect will be extended through December 31, 2021. This includes coverage for behavioral health services, in addition to physical, speech and occupational therapy, and medication management.”
And the press release quoted Craig Samitt, M.D., BCBSMN’s president and CEO, as stating on that date that “We’ve heard first-hand from our members and health care provider partners that virtual care is working to help address the needs of our communities at a time when in-person care may not always be available or preferred. We will continue to do right by our members in any way we can to help them through this challenging time.” BCBSMN manages care and coverage for 2.9 million members in Minnesota and beyond.
The press release continued on to state that, “Additionally, Blue Cross announced in early 2020 that it would cover all in-network COVID-19 treatment – including office visits and hospitalizations – at no cost to members. As the virus continues to take a toll on the physical and financial health of all, Blue Cross has elected to extend this additional coverage through June 30, 2021. The treatment cost-waiver applies to all members in fully insured commercial plans, which encompass thousands of small to large businesses throughout the state; Minnesotans who purchase Blue Cross coverage on their own; and seniors enrolled in Medicare. Self-insured employers have the flexibility to direct Blue Cross to administer the same change within their own health benefit plans. In accordance with federal law, for the duration of the public health emergency, COVID-19 testing and vaccine administration will also continue to be covered at no cost. To learn more about how Blue Cross is working to address the immediate and long-term implications of the COVID-19 pandemic, visit www.bluecrossmn.com/covid.”
Following the publication of the press release, Healthcare Innovation Editor-in-Chief Mark Hagland spoke with Mark Steffen, M.D., who has been Blue Cross Blue Shield of Minnesota’s chief medical officer for over two years, regarding the press release announcement and the broader frame around it, in terms of the health plan’s commitment to the health of Minnesotans. Below are excerpts from that interview.
How does the Feb. 10 announcement reflect your organization’s broader commitment to the health of your plan’s members?
Let’s start with the cost-share waiver piece. That, to me, is our commitment to the members whom we serve. We wanted to ensure that there weren’t barriers for people getting tested, treated, and now, thank goodness, vaccinated for COVID-19. And removing that cost-share made sure there was no financial disincentive for people to seek and obtain care for COVID. That was really the impetus behind that decision. That’s important to us from a mission perspective, in terms of supporting all of our members.
From your perspective, what’s the broader frame around this?
Let’s begin by talking about telehealth. Telehealth is one of the really interesting aspects of the pandemic. And it may be what we see as a silver lining as things emerge from the pandemic. We’ve always been in favor of using telehealth where appropriate, so that our members can get full access to care when and where they need it. And as an industry, we’ve seen the adoption of telehealth lag behind the implementation. And you can look back over a decade at some of the emerging telehealth technology, and how until recently, things haven’t come to fruition. But there’s nothing like a good emergency to spur innovation. And we were in a situation where, with broad stay-at-home orders, including here in Minnesota, we wanted to make sure that members could receive the care they needed.
So initially, this was about continuing access to Doctor on Demand, one of our large vendors; we waived cost-share for those visits, as well as any visits through the virtual model, through June. And we saw a significant increase in the utilization of telehealth during that time, and are continuing to see an increase in telehealth utilization, not only with the large national telehealth providers. Ut it was interesting to me to see how progressive our large health systems were in using telehealth to meet the needs our patients.
One of the unanswered federal policy questions is whether the Biden administration and Congress will move, after the end of the public health emergency, to extend payment parity for telehealth reimbursement. In your view, should it continue?
It’s hard to predict what CMS [the federal Centers for Medicare and Medicaid Services] will do. What we’ve seen through our own acceleration in this area, is we’ve opened up, similar to CMS, the types of visits that can be reimbursed through telehealth modalities. We are absolute supporters of telehealth and its incorporation in care models. And what I think is really going to have to happen as we get to the end of the pandemic, is that we have to have a realistic conversation about how these newly enabled care models add value to the members we serve.
We as Blue Cross are always thinking of members’ physical and financial health. We want these modalities to produce as good as, if not better than, non-telehealth-enabled care models, for our consumers. So I think that this is going to be a conversation that’s going to occur. I’m an optimist around this. Telehealth will likely slow down some, as you remove some of the stay-at-home orders—people will appropriately reengage with providers in person, getting some of their immunizations and preventive screenings that can’t be done through a telehealth model.
You are committed to reimbursing remotely delivered care?
We want to make sure that we’re reimbursing for the care that’s delivered. That’s going to be our goal. And what I think we’ll see is healthcare providers developing valuable care models. And as we’re looking at the value-based agreements that we have with providers in Minnesota, my hope is that they’ll be able to adopt these telehealth modalities, and we’ll move forward together with them.
What have been the biggest lessons from the pandemic for you and your colleagues at BCBSMN?
There are at least a coupe. I think we’re learning more about how people can and will access care. And I think this is particularly relevant to telehealth. I think it’s opened our eyes to the ways in which people want to interact with the healthcare system. I think we’ve heard from our members, and providers have heard from their patients, about what they like about those types of technologies. And I think it’s going to allow for some innovation in the space, as we move forward. So I think that that’s a big piece. The other thing that I’ve seen come from the pandemic is what we can do when we all chip in. I think that there’s been a wonderful response from health insurance organizations in totality and a wonderful response from providers, in everyone saying, we need to move forward and support all the people we serve. And it’s been wonderful to see all our health systems, public and private systems, responding to the emergency.
What does the next year-and-a-half look like for you and your colleagues?
That brings up another issue that we’ve learned in totality, and that is the vast health inequities that already existed before the pandemic. And though we benefit from having some of the best healthcare quality here in Minnesota, we also have some of the greatest disparities in the nation, and we’ve seen how the pandemic has exposed the disparities that exist and how it’s exacerbated them. It’s important that we focus on these marginalized populations, to make sure that there’s equitable distribution of the vaccine. And as we emerge from the pandemic, we’ll see greater recognition of the need to focus on all the disparities and all the health conditions that people experience. And my hope is that we see a renewed focus on that, not only from governmental organizations, from private industry.
Do you see an opening for federal healthcare policy change now, around this?
It’s always hard to say. I’ll focus on taking what we’ve learned from the pandemic, and use those learnings to drive better health among our members. Beyond that, I hope for the best.
What would you like to say to providers leaders right now?
You can put this in all caps: thank you! And I speak not only for Blue Cross Blue Shield of Minnesota, but for our members, for the patients they serve, and the state and country that we live in. I think they’ve been on the front lines in responding to this, and you can’t ask for anything more in terms of how much pressure they’ve been under, and how they’ve stepped up to the plate.
What would you like to say to the healthcare IT people in patient care organizations, about this?
This is a big opportunity. And as we go back to what we talked about with regard to health inequalities, there’s a big opportunity to look at the data and analytics capabilities we have, and to identify the people who need the most help, and then deploying care in different and unique ways that serve their needs. This includes things like telehealth, and understanding SDOH issues, and other factors that will determine their health outcomes.
Do you see yourselves using technology to communicate with difficult-to-communicate-with members?
We’re going out to talk with our members and listening to them, and working on things around improving members’ food security, for example. That’s the most important thing, that as we think about solutions to problems, that we go out and listen to the members we serve, and then to partner with them, and then to co-create solutions with them.
