Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.



The Member-Centric Virtual Service Model

Core member preferences are clear: members want health plans to offer them a convenient experience—from appointment availability and location, to parking and mobile interfaces—and affordable care, with known, specific costs.

But from confusing policy terms to unreliable coverage information, plans are falling short of consumer demands. As a result of this service gap, new entrants are offering members what they want: clear next steps and obvious prices.

Threatened by these new entrants, health plans want to improve their virtual interactions with members through phone, email, and web services, so that they can guide them to appropriate care. But these interactions rely on members to take the first step to enlist the plan’s help at the appropriate time—a rare occurrence.

Rather than rely on this reactive service model, plans must build their virtual service to immediately demonstrate how plans will deliver on member priorities. Read this report to learn four service hallmarks that plans should proactively prove to their customers, from personal relevance of any services promising convenience to the predictability of care costs.

Section 1 provides best practices to reduce the risk of introducing the Covid-19 virus with an effective screening process for staff, visitors, and admissions.

Section 2 offers guidance on training and supporting staff for strong infection control.

Section 3 advises on managing resident and patient contact to reduce potential transmission points.

Section 4 focuses on mitigating environmental hazards to prevent cross-contamination of Covid-19 and non-Covid-19 areas.


What SNFs need to know about preventing the spread of Covid-19
Read an overview of the challenge of Covid-19 in SNFs.

What SNFs need to know about Covid-19 testing
Get answers to frequently asked questions about testing in the SNF setting.

Review cohorting best practices
Learn more about cohorting patients by reviewing guidance from CDC, CMS, and AHCA.

1: Screening and admissions

2: Staff training and support

Help staff succeed under heightened precautions
Consider ways to best educate and support staff during the pandemic.

Ensure your Covid-19 response plan covers all relevant staff and issues
Review the CDC’s checklist for Covid-19 preparedness in nursing homes and other long-term care settings.

Use relevant resources for staff education
For example, use APIC’s flyers on PPE do’s and don’ts.

3: Reducing transmission points

Make contact efficient and effective
Learn how to provide quality care with significantly fewer contact points.

Identify new ways to offer virtual care
Consult the CMS Telehealth and Telemedicine Toolkit to evaluate options for telehealth and telemedicine during the pandemic.

Improve medication management
Review University of Maryland School of Pharmacy’s resources on optimizing medication management.

Provide person-centered care for individuals with dementia
Review special considerations for patients with dementia from the Alzheimer's Association and AMDA.

4: Environmental hazards

Mitigate environmental hazards in your SNF
Learn precautions to reduce and contain Covid-19 contamination.

Extend PPE use safely
Review CDC guidance on extending the use of respirators, facemasks, eye protection, and more.

Control air flow
For more information on controlling air flow, see APIC’s Infection Prevention Guide to Long-Term Care and consider these practical steps to improve air flow in SNFs.

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