Member Engagement in the Face of Disaster

October 4, 2018 Emmet O'Gara

In September we watched Hurricane Florence bear down on the U.S. east coast with dread. We collectively braced ourselves for the expected landfall in the Carolinas – the immediate impact and aftermath of disrupted lives, damaged property, and communities in crisis.

But behind the dramatic, non-stop media coverage a more positive story was unfolding. Instead of waiting to respond to a disaster after it happened, this planned and proactive outreach was designed to prevent additional impact on the health of those affected. Rather than focusing on dramatic rescues, flooding and destruction, teams were working behind the scenes to keep those in Florence’s path alive and healthy.

One of the most exciting shifts I see in the healthcare industry today is the growing emphasis on prevention and managing the health of individuals and populations, rather than the traditional exclusive focus on treating disease. Intuitively, we all know staying healthy and preventing illness is far better for our health and finances. This philosophy is baked into the mission of HMS' Eliza, where I’m responsible for finding ways to create and implement tools and solutions to make managing health a reality.

That’s what is equally exciting about the work we do. We help clients such as major insurance carriers improve their members’ health – which they demonstrated in a big way a few weeks ago. Enabled by a crisis outreach system developed and managed by Eliza, organizations like Anthem, Cigna and United Healthcare pulled off something remarkable. In less than 24 hours (one organization did it in less than six) they stood up a massive telephone-based outreach to their members in the projected impact area unprecedented in size.

More than 2 million calls were issued in the days leading up to Florence’s landfall, the majority of them related to the hurricane. This is the largest response to a specific issue in Eliza company history.

Members were reminded to make sure their essential prescriptions for medications were filled and that any other health or medical needs would be met for the duration of what lay ahead. Goals among the carriers varied from reaching the largest number of member possible to ensuring needs were met before case managers and service center staff themselves were affected by the storm.

Behind the scenes, these insurance organizations have extensive pre-planning in place that allows a rapid response. They’ve engaged their pharmacy, case management, IT, marketing and other teams to create their emergency response plans and be ready to act when emergencies happen.

They’ve also engaged HMS as a business partner to create the solution that enables them to reach massive numbers of members quickly. In short, they’ve moved from a reactive stance on disasters, to one that is proactive – where they take an active role in managing their member population’s health and well being.

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