by Clare Krusing
January 20, 2015
For Immediate Release
Washington, D.C. — A new study published today in the American Journal of Managed Care demonstrates that health plans have placed high priority on emergency preparedness and have implemented practices and policies designed to provide stability to consumers in the event of an emergency.
The study, authored by America’s Health Insurance Plans (AHIP), the University of Pennsylvania, and sponsored by the Department of Health and Human Services, reports on the results of a 2013 AHIP survey of its member plans. The survey asked for information about emergency preparedness infrastructure, plan adaptability, connectedness, and best practices to better understand the current state of the health insurance industry’s emergency preparedness.
“Our industry is committed to our promise of providing consumers with stability and peace of mind, particularly in emergency situations,” AHIP President and CEO Karen Ignagni said. “This report demonstrates the important steps that health plans have taken to mitigate disruption to consumers and to support broader emergency response efforts with public health officials.”
The study found that all health plans have emergency plans in place for business continuity, and 85 percent of plans have infrastructure for emergency support teams. The overwhelming majority (82 percent) of health plans routinely conduct internal emergency preparedness drills, and 59 percent have established benchmarks for preparedness (e.g., response time).
Approximately 85 percent of respondents have protocols lined up to extend claim-filing time, and 71 percent of health plans have a mechanism to temporarily suspend prior medical authorization rules. Further results show that in the event of an emergency, health plans are prepared to temporarily suspend business rules for pharmacy refill limitations and establish toll-free help lines for consumers in need of emergency support.
“For communities to respond effectively and recover quickly from a disaster, the systems people rely on every day to get medical care, including health insurance plans, must be ready to help patients rapidly during a disaster, so the study results are encouraging,” explained Dr. Nicole Lurie, HHS assistant secretary for preparedness and response. “Health plans play an increasingly important role in where and how people access care in emergency situations. We look forward to continuing our work with all health plans to strengthen and expand these capabilities to respond and meet patients’ needs in all types of disasters.”
Health plans’ emergency preparedness has been tested in responses to such diverse events as tornados, Hurricane Sandy, H1N1 influenza pandemic, and flooding in the Midwest and Southeast. In such cases, health plans proactively take the necessary steps to approve exceptions to normal coverage or payment policies so individuals can continue to receive the care they need and communities can recover. As noted in the article, plans also need to be prepared for public health emergencies as these unique circumstances can lead to business and technology interruptions.
The study identified opportunities for health plans to further advance their response efforts, including expanded use of metrics for evaluating emergency preparedness plans and policies, improvement upon digital strategies to enhance communication, and regular engagement among partners to share best practices in emergency preparedness.
The full report can be found here.
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