Kurt J. Wrobel, president of Geisinger Health Plan, provides the payer perspective on what the healthcare landscape will look like after COVID-19.
The COVID-19 pandemic greatly affected the healthcare industry, namely hospitals and health systems.
But the upheaval created by the virus also impacted the business model for insurers across the country. As consumer preferences and expectations for care changed, shifting towards virtual care services, payers adapted accordingly by adjusting reimbursements for telehealth visits.
Kurt J. Wrobel is president of Geisinger Health Plan (GHP), which has more than 500,000 members, and executive vice president of insurance operations at Geisinger, which owns 12 hospitals, urgent-care centers, outpatient facilities, and physician practices throughout Pennsylvania, including the flagship 574-bed Geisinger Medical Center.
In an interview with HealthLeaders, Wrobel provided the payer perspective on what the healthcare landscape will look like after COVID-19.
This transcript has been edited for clarity and brevity.
HealthLeaders: How do you expect the health insurance marketplace to change as the COVID-19 pandemic subsides?
Wrobel: How people receive care has started to change, with telehealth becoming a more important part of how people access care. From a purely insurance perspective, there have been material changes related to the ACA individual product line, with increased subsidies that allow more people to get insurance and become covered. I see those as two of the big [changes], which I think is largely positive with people being able to access insurance more readily due to the increased subsidies.
HL: What are your major priorities for GHP going forward?
Wrobel: [Let us start] with our North Star: what is our focus and what are we trying to accomplish from a big picture perspective? That gets into lasering in and ensuring that we have the best possible member and patient experience.
When it gets into service provided at the member level, it's the combination of people who are seeking care, looking for solutions and being able to access information from people who are based in the central Pennsylvania area.
But what’s also important is ensuring that you have the best possible technology to ensure that people can access information and data. Again, that's something, we're focusing on; we have a partnership with HealthSparq, for example, that has helped us ensure that people get access to the best possible information. That tight connection with members is going to continue to be important to us.
The other [factor] that will be important to us is ensuring that we provide an affordable product in the marketplace. We have done that, particularly, with our individual-based products, as well as ensuring the highest possible quality of care for our members.
HL: How should healthcare executives adapt their business models to rapidly changing consumer preferences?
Wrobel: It's important to consider and think about members as being the most important purchaser of care. One thing that we're seeing across all the lines of business, whether it's commercial, Medicaid, or Medicare is that there's increased focus on individual purchasing and the people making their own choices around the insurance product.
Within that, obviously, members are going to have a different perspective, in some cases, than traditional employers. They’re going to be focused on their own specific experience. We’re proud, at Geisinger, that we've won the J.D. Power Award for the second straight year for the commercial line of business in the state of Pennsylvania. Having that member focus is extremely critical.
I also think being able to provide accurate and meaningful information that's simple and usable at the member level is going to continue to be important. I think members are going to increasingly become more interested in not only access to care, but making economic decisions, looking at price transparency, and being able to look at different providers and choices as they get more involved in the pursuit of healthcare.
Those are two of the big [factors] with individual products becoming more important with members accessing information and care in different ways.
HL: Do you expect to see an increase in 'payviders' as hospitals and health systems look to establish their own health plans and diversify revenue streams? Why or why not?
Wrobel: [I expect that] is going to continue to evolve, but I see that as the direction of our industry. When you have that combination of payer and provider, we like to say, ‘That's where the magic happens.’ When you combine that information and those entities, you have access to better information that can allow providers to better direct care, which is critical.
You have a stronger connection between [payers and providers]. You'll have people at the call center or other places that have intimate information about the provider’s side of the house. All that allows our organization to provide better care, information, and a stronger connection with the health system.
It's also made better through a better connection and incentive as an entire organization to reduce cost and improve quality. When you have a traditional fee-for-service system where you have providers and health plans on opposite sides of the street, competing or sometimes in conflict, we don't think you get the best results. You can get the best result when there’s a connection between the two; when both entities are addressing the cost curve.
HL: We’re still awaiting a ruling in California v. Texas, the case that could determine the fate of the Affordable Care Act (ACA). How do you expect the policy towards health insurance to change at the federal level?
Wrobel: That's a tough one. The things that I would expect to see are continued involvement and engagement by individual consumers in both purchasing and accessing care. That's a trend that's going to continue and it's going to become increasingly important. One thing that we've seen with the passage of the ACA, thinking about our particular area in central Pennsylvania, has been a significant reduction in the uninsured rate and more people engaging in insurance products.
That's a trend that's going to continue. I think that engagement, both purchasing health insurance as well as accessing care, will continue regardless of whatever path the policy direction goes. That's an important [factor] and I think ultimately that's going to improve not just coverage but also people's health.
Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.