What health plans must know—and do—while members wait for a vaccine

A Covid-19 vaccine for every person is coming. And yet, a “return to normal” is still far off. Dr. Fauci and other public health experts say 70 to 80 percent of the U.S. population must be vaccinated before we can go back to some semblance of regular life. That’s a high bar given widespread vaccine hesitancy and skepticism on top of the logistical challenges of getting shots in arms. After all flu vaccination rates hovered around just 50 percent in 2019-2020. The fact is, we’re going to need to do much more than vaccines to keep people healthy in 2021 and beyond.

For health plans looking forward, know this: Now is not the time to become complacent. Uncertain if and when vaccinations will end the pandemic (especially with new highly transmissible variants of the virus), payers are asking: How long do we need to keep testing members for Covid-19?

From our perspective, we cannot ease up on testing protocols any time soon—and may need to double-down on testing. Here’s why:

The arrival of vaccines does not reduce the need for testing
To keep your plan members safe, payers need to broaden testing protocols through the end of 2021 — and perhaps longer. Questions about the length of immunity and whether vaccines protect against all the variants won’t be answered for some time. Like the flu, vaccinations for Covid-19 are likely to become an annual event. And if, like the flu, just over 50 percent of people get their yearly Covid-19 shot, testing will become a permanent fixture of public health – both viral testing to see if someone is carrying the virus and serology testing to see if a patient has developed an immune response.

Make testing more convenient testing
The good news is that we’ve learned a lot about testing and the virus itself, and in turn, innovations have been pushed to market, including less expensive, more rapid, over-the-counter tests for members to take from the comfort of their homes. Testing may always be with us, but it will get easier to do.

The imminent arrival of at-home tests signals that change is coming at last to the diagnostic testing industry – an industry in which traditional business models failed to pivot early on to support demand effectively. The failure of traditional players in the diagnostic testing industry to meet the challenge of the pandemic reveals a clear opportunity to transform healthcare by making testing more efficient and easier to access.

Innovations like rapid in-home testing put control of preventive healthcare in the hands of the consumer – where it belongs. Convenient testing helps those who are exposed and quarantining, essential workers risking daily exposure, and those with asymptomatic cases of Covid-19. Convenient forms of testing mean we can engage hard-to-reach vulnerable populations because convenience increases compliance. At BioIQ, we’ve seen compliance in completing and returning tests increase by 31 percent among vulnerable populations for colorectal screening simply by increasing the convenience of the test. And the same can happen with testing for Covid.

And that’s the point: We have a lot of room for improvement in making preventive healthcare convenient for the populations that need it most. Routine screenings from home are a game-changer for anyone with barriers to in-person care, whether lack of transportation or fear of exposure to the virus. To truly improve the health of populations, to reduce the rates of chronic disease and catch cancers early we need to focus on the last mile of care. We need to make it easy for people to get tested and then to take the next step toward getting the care they need.

Technology and data analytics can help
The good news is that thanks to the accelerated adoption of digital health tools like telehealth during the pandemic, the foundation is being laid for a new healthcare system that is tech-driven and more convenient and consumer-friendly.

Whether Covid-19 or cancer screenings, test results provide health plans with a window into member populations’ health and wellness. Payers can analyze that data alongside demographic and medical information to further understand and predict which groups are most at-risk for missed screenings, for more severe cases of Covid-19, and to understand the financial impacts of members skipping care. Then behavioral and demographic data can inform strategies for targeted efforts to close gaps in care among members. Technology and data can also help health plans tailor and personalize care for their members, nudging them to take the next step in managing their chronic condition and connecting them to the care they need.

Cover the last mile
As Covid-19 joins the ranks of cancer and chronic diseases to be tracked and prevented through testing, health plans will need testing solutions that can be distributed quickly and at scale. The Defense Production Act invoked by the Biden administration will ensure that 61 million point-of-care or at-home tests will available to Americans by the end of this summer. How will you get those convenient tests to your members and what will they do with the results? Now is the time to determine your last-mile strategy to protect the health of all your members.





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