Discussions:101,499. |. Messages:1,352,505. |. Members:85,225


Medicare Advantage industry adapting to COVID-19 challenges

Insurance Forums Staff

While many physical locations are closed during COVID-19 containment efforts, the Medicare Advantage industry continues serving the nation’s most vulnerable population.

However, operations are rapidly changing according to Patrick Phillips, CEO of Cavulus, a leading technology firm serving the MA industry.

“On the tech side, companies are pivoting to work from home (WFH),” says Phillips. “Our company has embraced a remote structure since our launch in 2006, so we’re busy helping industry peers navigate this change. In our regulatory environment, it’s not as simple as setting up remote communications. HIPAA, PHI, CMS and security mandates must be upheld.”

Patrick Phillips

The initial WFH transition may be difficult, but Phillips says he believes companies will see a silver lining, noting, “the remote model enables us to recruit top-tier talent around the country and invest in our team and technology rather than physical space. We’ve even seen business continuity bolstered with employees dispersed geographically.”

From a payor perspective, Phillips envisions Medicare Advantage sales operations relying almost entirely on call centers in the next 12-18 months. “MA plans will not jeopardize the health of our population with home-visits and public seminars. Those activities will cease until there’s a vaccine that makes in-person contact safe. But there’s never been a more critical time to communicate accurate information to beneficiaries.”

According to Phillips, this disruption is driving activity in the MA market as plans engage third party call centers and software vendors. In doing so, he recommends plans scrutinize security, remote capabilities, server redundancies, back-up frequency, and historical metrics like recovery time.

“These are critical factors in times of crisis and are being increasingly tested due to recent hurricane evacuations, wildfires and other natural disasters,” Phillips says.

“There’s a new reality. The movement to WFH has been evolving, but today’s challenges have accelerated it dramatically. There’s no substitute for those on the front lines of this war with COVID-19. But for anyone who can provide support remotely, our digital environments must be adaptive, flexible, and most importantly, safe.”

About Cavulus: Pittsburgh-based Cavulus is a technology-driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud-based Medicare Advantage Platform (Cavulus MAP) unifies marketing, sales and enrollment operations, and utilized by many of America’s top insurers, including several BlueCross/BlueShield companies, UPMC Health Plan, Johns Hopkins Healthcare, Lumeris and United Healthcare. For details visit www.cavulus.com.



Leave a Comment