Pandemic Response: Organizations Move to Erode Health Care Barriers

Stacy Van Alstyne, CEBSMay 13, 2020May 13, 2020

As the coronavirus pandemic took hold, some organizations adopted safer-at-home work environments, while others were deemed essential and saw their work shift from routine tasks to risk-taking heroics. Others were forced to furlough staff. All situations affected how participants access health care, and their demand for various for services. The pandemic’s psychological imprint on workers, while varied, increased the need for mental health services.

Employers have found themselves making quick adjustments to their health care benefits to meet participant needs. The International Foundation’s survey, Employee Benefits in a COVID-19 World, explored how organizations have adjusted their benefit plans in response to the coronavirus pandemic.

A Shift to Virtual Access of Health Care

With in-person visits for non-emergency care severely curtailed by official guidelines, employers made swift moves to make access to health care virtual. While the majority of respondents (83%) already offered telehealth/telemedicine services for physical ailments, an additional 13% have implemented these services due to COVID-19. Nearly half (49%) of respondents reduced or eliminated cost sharing for telehealth/telemedicine services. Nurse advice lines were readily available by most organizations prior to the pandemic, and now one in ten (11%) are reducing or eliminating cost sharing for these services.

[Upcoming Webcast: Capping Medical Plan Costs and Improving Care in the Aftermath of COVID-19 | May 21, 2020]

An Increase in Mental and Behavioral Health Benefits

From isolation to the devastating emotional toll on first-responders, the pandemic’s effects on mental health are mounting. While 17% of respondents have added services to their existing mental health benefits, another 21% are considering doing so. Ten percent have reduced or eliminated cost sharing for mental/behavioral health benefits and another 9% are considering doing so. Telepsychiatry has been added by 15% of organizations in response to COVID-19 and another 11% are considering.

Changes Made to Mental health Benefits Due to COVID-19

Changes to the Rules for Prescription Drug Benefits

For many plan participants, the use of maintenance drugs is critical to preventing a major illness and managing chronic conditions. Recognizing the pandemic’s ramifications on accessing prescription drugs, organizations made several adjustments to their plans. Of organizations that offer prescription drug benefits, about two in five (39%) have extended the time allowed under prior authorization periods for prescription drugs. A smaller number have waived prior authorization requirements for prescription drugs (16%). A typical prescription limit before the pandemic for many maintenance drugs was a 30-day supply. Because many people are trying to limit their exposure to others and follow safer-at-home recommendations, nearly a third (31%) of organizations polled have increased their prescription quantity limits due to the pandemic.

Changes Made to Prescription Drug Benefits Due to COVID-19

Health Care Benefits in a COVID-19 World

The pandemic has dramatically changed the lens in gauging sound plan design. Some of these benefits, such as telepsychiatry, were seen as novelty just a few years ago. Plan structures set in place to keep participants safe, such as prescription drug preauthorization or quantity limits, have been loosened, but are still maintained out of concern for patient safety. As the pandemic’s reach continues to expand, it is quickly reshaping our day-to-day lives, including what was once a relatively slow-to-evolve health plan design.

Download the full report: Employee Benefits in a COVID-19 World: April 2020 Survey Report to learn more about how employers are reacting to the COVID-19 pandemic.

Employee Benefits in a COVID-19 World Survey Report

Visit the International Foundation Coronavirus (COVID-19) Resources page to find even more resources for plan sponsors including these upcoming Foundation webcasts: