07 May, 2020

By Mark Harris

Access to care during a pandemic is a major issue for employers and employees alike, but there are solutions available to help.


The Covid-19 pandemic has collided with the recent trend towards the consumerisation of healthcare. For the first time, patients are transforming from passive recipients of healthcare services to being active participants in their own healthcare journeys – and Covid-19 will accelerate this.


This fundamental shift in people’s preferences, behaviours and demands around healthcare services has been enabled by the sort of technological developments that have enabled so many to work from home.


Remote working brings its own unique challenges from a health perspective. The key challenges facing employees and their dependents around access to healthcare during this pandemic can be grouped into three main areas:


1.      Access to elective care services


From a service perspective, the access to elective care is probably the main challenge facing everybody at this time. How can people get to a hospital or clinic? Increasingly, services will have to come to the individual, and there are new products available in the market to enable this.


The other issue to arise is accessing care in an emergency situation. Covid-19 has caused some interesting evacuation and repatriation challenges, including the first ever evacuation we’ve seen from the UK to Germany. A German national was struggling to access care with suspected Covid-19 symptoms – nearly all foreign nationals must pay for using the NHS. After an assessment, his insurer undertook a repatriation of the individual back to Germany.


For businesses supporting employees in remote locations globally, the number of emergency air ambulances equipped to deal with Covid-19 is highly limited and the costs of evacuations have increased dramatically, due to reduced availability of air ambulances.


2.      Financial implications for employers


There are some broad financial implications from this limited access to care over the coming months. With employees unwilling or unable to visit hospitals, insurers are expecting a significant reduction in elective treatment costs, but with the potential for this to snap back towards the end of the year depending on when and how quickly lockdown eases.


One insurer has reported that claims volumes were down by a staggering 40% in April compared to April 2019. However, psychiatric claims were 45% higher over the same period. On the subject of mental health, our Mercer Marsh Benefits Covid-19 website has some useful content around managing employee mental health at this time.


3.      Compliance issues


The third area, especially for businesses managing internationally mobile employees, is the issues around compliance with admitted insurance requirements in many markets.


We’ve been working with a number of clients whose internationally mobile populations are effectively ‘stuck’ in other countries. They might be staying with relatives or in holiday homes, and this brings up multiple challenges relating to existing plan provision: are there any exclusions for overseas cover, or potential local compliance requirement issues, for instance? These situations are complex and need to be worked through almost on an employee-by-employee basis.


Finding the right solutions


What are the solutions available to meet these challenges? The tools and services that have been developed over the past few years to address the consumerisation of healthcare are helping. Many providers, for instance, now offer access to telehealth or telemedicine solutions which allow employees to download an app and book a consultation with a registered medical practitioner. Many also have e-prescription capabilities so employees can get prescriptions through the post.


Services like this are a great tool for accessing care from home - employee satisfaction with telehealth solutions is running at about 98%, and they bring a significant reduction in outpatient costs for employers. The pandemic will bring a step change in terms of telehealth usage - in Wuhan, China, where the pandemic began, local telehealth platforms have experienced an increase by a factor of ten in terms of usage, and we can expect to see similar changes in the UK.


Some providers are also offering ‘healthcare at home’ solutions which involve a GP or physio coming to a patient’s home. This sort of services is normally limited to big cities, but if you have a large population of employees that is matched to provider capabilities, this sort of service can be invaluable during a crisis like this one.


The services available will continue to evolve. DNA tests sent through the post, for example, are continuing to improve and can help people better manage their diet, exercise and stress levels, improving long-term health outcomes.


In conclusion, this is a challenging time for employers and employees alike. But there are solutions available to help. If you’re fortunate to have some of these already in place, remind your employees to take advantage. If you don’t yet, now is the time to look into solutions. 


If you would like to talk to someone about any of these issues, contact mark.harris@mercermarshbenefits.com 


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