Health Plan Weekly

Health care organizations, eager for innovative ways to engage members in the midst of the pandemic, ramped up their use of email and texts in 2020, and found they were highly effective in prompting consumer action, a recent survey on health care consumer engagement found.

The survey, conducted annually for the past five years by consulting and research firm Engagys, found when it polled around 100 health care entities in November that 2020 had been a “breakout year” for use of more efficient digital channels and personalized messages, says Kathleen Ellmore, the firm’s co-founder and managing director.

An earlier version of this story incorrectly stated that Psych Hub is creating “provider ratings.” A Psych Hub representative tells AIS Health that the company is instead “working to identify universal quality outcome measures.” This version has been corrected to clarify that distinction.

With unmeasurable stress and trauma caused by the pandemic, the U.S.’s longstanding shortage of behavioral health care has become an acute crisis — making improvements to the way treatment is paid for a more urgent issue than ever. Fortunately, new trends in quality measures, network design and reimbursement could help the health insurance industry improve access and affordability for behavioral health care to members.

If Chiquita Brooks-LaSure is confirmed as the next CMS administrator, the managed care industry can expect to see a thoughtful and experienced leader helming an agency that wields vast regulatory power over some of insurers’ most lucrative business lines, industry experts say. However, that doesn’t necessarily mean that every move taken by Brooks-LaSure, HHS secretary nominee Xavier Becerra or the Biden administration at large will be completely industry-friendly.

Dan Mendelson, founder of the consulting firm Avalere Health, suggests that “the health insurance industry can expect her to look carefully at the issues before acting; she’s not an impetuous person in any respect. That thoughtfulness is pretty much a hallmark of her operating style.”

✦ Multiple news outlets were reporting at press time that President Joe Biden was expected to nominate Chiquita Brooks-LaSure as the new CMS administrator. Brooks-LaSure, who currently is a managing director with Manatt Health, previously served as deputy director for policy at the Center for Consumer Information and Insurance Oversight within CMS, and as director of coverage policy at HHS, playing a key role in passing and implementing the Affordable Care Act. Read more about Brooks-LaSure at https://bit.ly/3pBfgDc.

✦ Analyses are rolling in for the provisions in House Democrats’ COVID-19 relief proposal that would increase ACA subsidies for two years. The Congressional Budget Office estimated that a pair of provisions in the relief package — which would temporarily increase the value of ACA subsidies for those who already qualify and extend subsidies to people who previously weren’t eligible — would cover about 1.3 million uninsured people in 2021 and cost the federal government about $34 billion. Separately, a new analysis from the Kaiser Family Foundation found that “the vast majority of the nearly 14 million people already insured through the individual market would see lower premiums under the proposal” and that “most of the roughly 15 million uninsured people who could buy coverage through the marketplace would be eligible for new or bigger subsidies.” Read the CBO analysis at https://bit.ly/3ubYrT6 and the KFF report at https://bit.ly/3k2YprU.

Experts in primary care say the field has still not resolved long-term financial and structural challenges exposed by the COVID-19 pandemic. They also point out that primary care must play a central role if the health care industry will successfully confront the structural racism and inequality made worse by COVID-19.

In a Feb. 17 virtual event organized by the Robert Graham Center, a think tank that studies population health, family medicine and primary care, panelists described the financial challenges posed to primary care by the pandemic, which include accelerating consolidation and a problematic reliance on fee-for-service revenue. The panel, which featured executives, researchers and practitioners from organizations including CVS Health Corp. and UCLA, also observed that PCPs are on the front lines of population health challenges caused by structural inequality — which the pandemic has made even worse.