JIN OAK HA: Today's session will be hosted by our Chief Medical Officer
Dr. Wendy Shanahan-Richards, and will provide an update
in terms of our COVID-19 response,
including how we are supporting our students through the pandemic
as well as a facilitated discussion about how our schools are responding
to the pandemic as well as planning for the post-pandemic
in this COVID-19 environment in our path back to campus.
We will also be joined by Peter Diniaco, who is our Head of Sales
and Account Management, who will be on the line with us today
and will share a high level overview of our CVS Health offerings
for our schools as they plan their return back to campus.
And I would also like to take this opportunity to reinforce
CVS Health and Aetna’s commitment to supporting our schools
providing not only support and solutions
but also our support supporting student health,
customers and members during these unprecedented times.
So with that I will hand off the webinar
to our Chief Medical Officer Dr. Wendy Shanahan-Richards.
Dr. Wendy?
DR. WENDY SHANAHAN-RICHARDS: Yes, can you hear me. Can everyone hear me, okay?
JIN OAK HA: You're good.
DR. WENDY SHANAHAN-RICHARDS: Excellent, okay.
Well I'm going to say good day to everyone
because I know people are participating from different time zone.
And I also would like to express my thank you
to everyone for spending time with us today.
I’m going to, if you can see the - we'll be pulling up the agenda here momentarily
and you'll see that, you know, we have quite a busy agenda here.
But we are definitely planning to allow for time to hear from you
about your strategy for recovery and path back to campus.
And we will also allow adequate time for you to ask questions.
So the approach that Aetna Student Health as part of the CVS Health Organization
has deployed to support our members, our providers and our schools
during the pandemic has been to really focus on making it easier
for members to receive care and utilize their benefits appropriately.
And of course for providers to deliver care in the midst of this pandemic.
For the next 15 minutes or so, I will cover at a very high level
some of the many ways that our organizations
have supported our members, our schools and providers
during these challenging times.
Afterwards, we’d like to hear from you
and we'd also like to invite you to ask us questions.
I'm going to start off with talking a little bit about the benefit liberalizations
around testing and telemedicine,
our international students,
how Aetna and CVS Health are helping to fight against COVID-19.
We'll then move on to talking about some of the policy liberalizations
that our organization has instituted during this time.
I'd like to address case management outreach to support and education
that has been really enhanced during the pandemic.
And then we'll finish with just a very high-level overview
around transparency and communication.
And then finally, we're going to talk a little bit about
what the path forward looks like, the path toward recovery,
and this is where we really want to hear from you
because, you know, you're living this every day
as you plan, you know, for fall and going forward.
And then we will take questions.
So let me start off with benefit liberalizations,
you know, what I'm going to say here is not all inclusive
and, you know, timelines have shifted and evolved
as the pandemic has progressed.
But again, at a high level around benefit liberalization,
you know, one of the very prominent topics has been around COVID-19 testing,
both the viral or antigen testing as well as the antibody testing.
And I'm sure that you're all aware that the cost share to members
has been waived for this testing and is still continuing to be waived.
For telemedicine, which has become, you know, it's just an incredible
resource for your students, our members to receive care,
we have also waived the cost share for the telemedicine services
from our in-network providers.
We've expanded coverage of telemedicine services.
So you may remember some of you have had students that, you know,
needed to continue their physical therapy, occupational therapy, speech therapy
during the time when they were not able to see their providers in person.
So we've expanded the services covered around telemedicine.
We've also made it possible to adjudicate the claims
for international telemedicine in line with international plan coverage.
And finally, we have allowed student health centers
to bill for telemedicine visits.
And we know that this is really, really important to you
and to your students because many of your students have had, you know,
a working relationship with your student health center,
and we wanted to make sure as I know did you,
that this did not diminish as much as possible during the pandemic.
So the billing has been facilitated to take place
either through a fee for service or through health center billing agreement.
Acute inpatient admissions.
You know, in this particular area that I'm going to talk about,
this has been so serious across the country, across the world.
Many, many admissions, people having various experiences with this virus.
And so we have waived the cost share and copay for all COVID-19-related admissions
at all in-network and out-of-network facilities.
In terms of pharmacy, CVS Health and Aetna Student Health, of course,
have permitted a 90-day prescription supply and refills at retail,
as well as provided free home delivery,
which again is incredibly important during this time.
And for members outside of the United States,
particularly covered students studying abroad we've
made sure that they were covered at 100% for COVID-19 testing.
And finally, for international students,
expanded coverage for eligible plan medical services
at in-network benefit levels for students that are traveling
outside of the United States.
I know specifically in terms of our clinical team
we have worked with some students who were traveling abroad,
they were studying abroad when all this started
and they were not able to come back to the United States at that time.
And so we wanted to make sure that, you know, they were able to be treated
and that this would be at the in-network medical level.
And now I’m going to move on to policy liberalization
and, you know, this is an area that I've been very, very involved
with the Aetna/CVS Health enterprise.
Making sure that we had a voice at the table
because we do know that our students' needs are sometimes different
than the typical, you know, adult employee population.
So one of the first things that occurred was
that for approved pre-certification for some of our ambulatory services
the end of the timeframe for which that precertification was valid.
And, you know, it's usually six months from the time that the provider calls in
and ask for the precertification and the approval is good, if you will,
for six months; we extended that to nine months.
Also too, for acute-care admissions in select states,
we made sure that the facilities who were just in many cases
not just busier than usual but bordering on being overwhelmed,
especially back in March and April.
Made sure that they just needed to notify us for that admission,
they did not need to send clinical information,
they didn't need to talk with our utilization management staff
every other day to provide clinical.
Again the focus was on, you know, making it easier for the students
to receive care and for the providers to render care.
We also know that some of the students, and numbers just in general,
depending on how acutely ill they were, you know, when they were admitted,
some of them did need to progress to a lower level of care
before they were ready to go home.
And so we make sure that the policies around notifying
and getting approval for that transfer was altered so that it was again
not dealing any kind of transfer of students from the acute level to sub-acute.
I’m going to talk a little bit now about case management.
So many of you that I have spoken with, you know, or that your
Aetna Student Health account management representative has spoken with in the past
know that we have a very, very active case management program
in Aetna Student Health.
This includes medical as well as behavioral health.
And so we wanted to make sure that for all the members that we had been
working with in case management for any reason since late last year,
even if they were not in active case management
that we would reach out to them, see how they were doing.
Determine where they needed support, answer their questions.
And so our team really had a huge rally of outreach calls
and, you know, engagement with the members.
Each and every member that was hospitalized
either with confirmed or potential COVID-19 was outreached upon discharge
so that they could, again, get additional support and ask their questions.
And this again was very well received by the students.
If any member called customer service and self-reported outpatient care
for COVID-19 we also reached out to them because they didn't have the benefit
of having, you know, clinical staff in a facility
to help them with their discharge planning.
We wanted to make sure that they were getting the resources
that they needed as well.
And finally, we know that this pandemic has had a very large impact
on students and members who have various medical and behavior health diagnoses
that might put them at higher risk of COVID-19 or related issues -
and particularly in the behavioral health arena.
And so we reviewed all of our data and we reached out to members
who, you know, we are aware are challenged with various diagnosis,
and we made reach-out calls to them as well.
Another really important resource that we are able to leverage
during this time has been Resources For Living (RFL),
which is a component of Aetna behavioral health.
They have provided a very, you know, wide ranging, but very comprehensive
list of support organizations, community organizations.
They also provide online access to a toolkit,
which gives very relevant and current up-to-date information on COVID-19.
So all of our clinicians that were speaking to members for any reason
during this time, if they had a sense that the member needed more information
and that they needed additional support they're able to refer them
to the Resources For Living.
Talking little bit about CVS MinuteClinics.
So they have played an important role during the pandemic as well.
They have and they continue to offer e-clinic visits
where the nurse practitioners and physician assistants
that are part of the MinuteClinic organization
were covered under telemedicine benefits
and also included the member cost share waiver
that students that would be working with clinicians
in any other venue of telemedicine would have.
CVS MinuteClinic also provided video visits,
which were staffed by Teladoc physicians,
again covered under the telemedicine benefits
including the member cost share waiver.
I’m going to talk a little bit now about testing support that has been offered
and the first one I'll mention here is the rapid drive-through testing,
which is very large scale.
It is by appointment, it's seven days a week.
There are five large scale testing locations in various states,
and the process includes a self-administered nasal swab
and the whole process is really under the supervision
of the CVS MinuteClinic providers.
The process takes about 30 minutes from the time the specimen is collected
to the availability of results.
This has been very, very popular and heavily utilized
throughout the time of the pandemic.
You also have drive-through testing available at CVS Pharmacy locations,
again by appointment.
And by the end of May, we reached over 1,000 locations
including Washington D.C. and more than 30 states.
The same process is in place with the self-administered nasal swab
and the process is under the supervision of MinuteClinic staff.
So again, many times when there are questions during the testing
or some anxiety during the testing process,
it’s just very, very important to have clinicians that, you know,
can help people understand what the testing processes is
and, you know, when the results will be coming in,
and what their next steps would be.
The specimens in this case are sent to an independent third party lab
and the results are available in about three days.
So again, depending on the needs
there are a couple of options that have been available.
And speaking of other options at this point I'd like to turn
the presentation over to Peter Diniaco,
one of my colleagues at Aetna Student Health
and he's going to address the new opportunity that CVS Health
and Aetna Student Health are offering to customers.
So Pete, I'll turn it over to you.
PETER DINIACO: Thank you, Dr. Wendy. Good day, everybody.
So as Dr. Wendy mentioned CVS has developed a comprehensive solution set,
which offers flexibility in the location of testing
as well as the timing of results.
All wrapped with a robust data and analytics reporting package.
We understand the need for flexibility and the sense of urgency
as you look to safely reopen your campuses.
So it is designed to be highly configurable.
It's a turnkey end-to-end offering that enables your school to choose
who to test from symptomatic, asymptomatic,
those that have been exposed and recovery validation.
It allows you to choose where to test whether it'd be on-site
or even prior to the students returning to school
as well as the speed and the frequency of testing.
This is a really important distinction to note.
This is not insurance coverage or part of an insurance plan.
This is a separate offering.
It's a separate standalone program for you to consider
that allows for the proactive screenings and frequency.
It can also be comprehensive to include faculty and administration.
So there's two models.
The first model is on-site testing.
On campus, utilizing the Abbott ID now rapid result machine.
The results using this machine are available in about 5 to 15 minutes
and each machine has the capability of doing about 30 tests
in an eight-hour shift for a machine.
The second model is taking advantage and utilizing the 1000 locations
that have the drive-through capability to do the nasal swab
and send with the PCR tests to an independent lab.
And the result takes anywhere from two to four days to get the results of the test.
I also did want to mention that each of these testing models
use our antigen test, not antibody test.
And, you know, in the spirit of the configurability of the offering,
a school could choose to deploy a hybrid model
and you utilize both the on-site as well as the drive-through
if that works in your particular case.
You know, in a little bit more detail on the on-site in that case,
it is turnkey where CVS would come in
and basically provide two clinicians per machine
to administer and counsel the students with results.
They come in and actually build out the space that's provided
to ensure that it's compliant and suitable as a testing environment.
In addition to providing the space, the other primary task we would need
from the school is to provide an eligibility file for the populations you choose to test.
So that would be both for on-site but in particular,
if you were going to use the drive-through function.
The other convenience of the drive-through is it’s a direct bill model.
So there's no exchange of money, you know,
for everybody that goes on to the scheduling -- the CVS scheduling tool -- a student
there would be a charge back to the school
for those that actually go through and get tested.
And the cost of the program just to give you some ideas
based on, you know, which model you deploy and for the length of time.
But just to give you some guidance the on-site is $200 –
it breaks down to about $200 per test.
The drive-through model is $165 per test.
So I just, I know that was a real quick overview
and I want to do this quickly and just to give you that overview
but we're available to do a much deeper dive with those who are interested
in learning more and exploring how this could fit your return-to-campus strategy.
So with that in the interest of time Dr. Wendy,
I’ll turn it back you to continue, please.
DR. WENDY SHANAHAN-RICHARDS: Thank you, Peter.
So a few other areas that I'd like to cover before we move to our next section
is we did offer a special enrollment period during April.
So many of us in many ways were I guess you could say, you know,
turned around a bit by this pandemic.
And so for students and their eligible dependents
who have previously waived coverage or who had a qualifying life event,
we wanted to make sure that they had the opportunity to enroll
during our special enrollment period.
I'm going to, you know, finish by talking a little bit
about transparency and communication.
You know, I've heard from a lot of people and I felt this myself
and I am sure many of you have as well that as we have had
to practice social distancing and during the various states’ stay-at-home orders,
we've had to learn new ways of communicating.
You know, we don't see each other in person
as often nearly as we did in the past and we are hoping those days
will come back relatively soon.
So transparency and communication with our schools as well as our students
have been very, very important to us in terms of what our focus has been.
And I will just mention a few areas that have been deployed.
So, CVS Health has had, I think, it has an excellent COVID-19 resource center.
We will be providing a link later if you don't have it.
This link will be going out after the meeting;
it is publicly accessible, it's updated very regularly
and I use it myself for a variety of reasons.
I think it's a great resource.
In terms of the Aetna Student Health and team and how we have been
fostering transparency and communication,
our leadership team meets every day.
We formed a multiple-disciplinary team back in March
to address emerging topics and questions
that you our schools, our members, and our providers have.
As I said, we meet every day
and we make sure that we have a central repository for all questions
from our schools as well as our members
so that our team, our entire student health team,
from customer service to account management
are able to provide consistent updated current responses and information to you
and to your students when those questions arise.
We also have been very fortunate to have a very comprehensive FAQ document
around the virus and it's regularly updated.
Our account team has access to it.
And I know that they utilize this resource very heavily
when they're responding to your question.
And I would be remiss certainly not to mention the account teams;
they and customer service both are the face of Aetna Student Health.
And I know that both the customer service and the account teams
have been working very, very hard during the pandemic
to make sure that they're available for you,
to make sure that they have the answers to the questions
that you need, you know, very quick answers to.
And so they've been, again, excellent partners
with the leadership team and we really appreciate all of their work.
We also, you know, are fortunate to have our network manager
that is linked in to the CVS Health Network teams.
Many questions coming in from providers around benefit coverage
and she has been able to field those questions
and bring a lot of valuable information not only to the provider but back to us
so that we can understand really the line of sight that we need to have
in the challenges that they are experiencing during the pandemic.
And then finally, monitoring our metrics through analytics;
you know, there's a lot of data out there.
We see the data – we see reports from the CDC.
And, you know, frankly, I can get overwhelmed by that sometimes –
a lot of good data, a lot of good reporting.
But we wanted to really focus – while we certainly pay attention
to what's going on in the world, in the country, and our very state,
we wanted to focus on our Aetna Student Health analytics and data.
And so we have developed a daily dashboard that we use amongst our team
to monitor and track our metrics related to the virus –
around the services such as testing, telemedicine, inpatient hospitalization.
How are these services being utilized?
Do we need to make more adjustments in terms of our communication about them?
And then finally in May, the Aetna Student Health DASH reports
that many of you are familiar with for each of your schools
began including COVID-19 specific reporting
so that you could have more line of sight into, from an analytics standpoint,
the impact that the virus may be having on your student population.
And so now, I've really completed my prepared remarks,
but what I'd like to do is under Recovery, "What does the path forward look like?"
This is where we really want to hear from you.
Like I said earlier, you know, you live and breathe this every day.
And I know that there are huge challenges that you have been confronting
and we're looking forward to hearing more about
how you were approaching the return to campus in the recovery process.
I think as our country gradually opens up during the pandemic,
our schools as well as employers are grappling with decisions
around returning to campus and returning to work.
We are hearing a lot from our schools
that they are focused on a number of key areas
as they contemplate their next step on the path back to campus.
And these I'm sure are very obvious to you but, you know, testing for the virus,
viral testing versus antibody testing.
Vaccine availability timeline, you know, we hear different things around the timeline,
depending on the day of the week and the month that we're in.
And we're all very hopeful that that timeline can be accelerated,
but we just don't know at this point.
Also hearing about managing on-site learning versus distance learning,
the challenges that has and will continue to provide.
Athletic events, campus events, you know, things that we're all used to
that are traditionally, you know, part of the higher ed experience.
What are next steps with that?
How can we help the students still have access to various activities
when we can't all be there in person?
And then, you know, we've heard from our school that models under consideration
are full return to campus, or completely maintaining distance learning,
or various types of hybrid approaches.
What I would like to do at this point in time
is to turn it over to Jin Oak.
So we did invite our participants to submit questions prior to the webinar.
We did receive some questions that we would like to go ahead
and review those first and then we will open up the lines for Q&A.
So Jin Oak, I’d like to turn over to you, please.
JIN OAK HA: Thanks, Wendy.
So we received a number of questions and I'm hoping that, you know,
these are general enough for pre-submitted questions
and if not feel free that ask more detailed questions but let's get started.
So to Dr. Wendy.
"So as schools are planning for various scenarios for this fall semester,
what is Aetna planning to support for their customers and their schools
by way of benefit liberalizations?"
DR. WENDY SHANAHAN-RICHARDS: Okay, thank you. Thank you, Jin Oak.
So, you know, I talked a lot about the benefit liberalizations,
you know, during my remarks.
But I wanted to make sure that there have been
a lot of different benefit liberalizations, kind of they all fit together.
Some examples would be, you know, waiving cost shares for testing and treatment,
certainly for telemedicine, waiving referral requirements
as well as expanding coverage for international students.
And we have extended our telemedicine coverage at no member cost share
through the fall because again we do not, as I know you don't,
either want students to have to delay care
because they are not able to go in and see their provider in person.
So just a brief summary of what we have been doing.
JIN OAK HA: Great, thank you, Dr. Wendy.
Another question:
"There has been an unprecedented use of telemedicine during the pandemic.
Can you speak to how Aetna has supported members
with telemedicine options and access
and how Aetna now has been working with the student health centers
on expanding telemedicine access?"
DR. WENDY SHANAHAN-RICHARDS: Sure. I'd be happy to.
So just as national experience has shown us
there has been a very, very large increase in telemedicine utilization
for both medical and behavioral health care.
I think it’s unprecedented just like this pandemic is,
it's unprecedented for so many providers
to have had to move to the telemedicine model in a very, very short period of time
to continue to provide, you know, consistent care to their patients
and again certainly that includes the clinicians
at our schools’ campus health centers.
And so we wanted to make sure that whatever we could do in our role
that we could make it easier for that to happen.
And so we did liberalize telemedicine benefits by waiving the cost share
and particularly we've seen a very, very large increase
in behavioral health telemedicine usage.
We've also – I think I mentioned this during my remarks too –
we've also made sure that it was going to be as easy as possible
for the students to receive telemedicine care through their student health center
in the event that, you know, that was the area
they had been receiving care prior to the pandemic.
JIN OAK HA:Thanks, Dr. Wendy.
Another question:
"Aetna is covering costs for COVID testing and treatment.
Are ancillary services tied to COVID testing and treatment included in coverage?"
DR. WENDY SHANAHAN-RICHARDS: Absolutely. So under federal mandate,
we certainly have been covering –
the various states have had orders to cover inpatient care without member cost share.
But we've also made sure that on the outpatient side
any services that are tied to COVID-19 testing are covered
with no member cost share.
Because, again the last thing we want people to worry about
when they believe they may have been exposed to the virus
or they're having symptoms of the virus that they're thinking about,
Oh, let's see, what's my deductible,
or wondering what I'm going to have to pay out-of-pocket.
We want to make sure that wasn't going to happen,
and of course it just goes without saying but, you know, we follow very closely
and adhere completely to any kind of federal or state mandates,
regulatory requirements for all health care services,
and certainly that includes COVID-19-related healthcare services.
JIN OAK HA: Thanks, Dr. Wendy.
Peter, here's one for you:
"As schools are planning for various scenarios for the fall semester,
what is Aetna planning to support for their customers
by way of testing capabilities?"
PETER DINIACO: Yeah, just as, you know, a quick recap I think that the program
that I described, which I think I failed – the name of the program is Return Ready.
So the level of support is really around the on-campus capability
with the rapid result machine or if the school has proximity
to one of the 1,000 CVS drive-in locations, that could be an option as well.
Or, you know, that could also be something that schools ask students
to get tested before they return to campus by utilizing those.
So those are the two levels of support in that regard, Jin Oak.
JIN OAK HA:Thanks, Peter.
So one last question, Dr. Wendy, for you:
"Aetna has expanded case management outreach to members during the pandemic.
What community-based outreach support and interventions can Aetna offer
to schools in their recovery efforts on their path back to campus?"
DR. WENDY SHANAHAN-RICHARDS: Excellent question.
So our case managers have provided outreach and engagement with members,
you know, as I had mentioned before.
And I also mentioned Resources For Living, also called RFL,
that our case managers have tapped into those resources to share with our students.
We occasionally will have a situation where, you know,
someone has contracted COVID-19 and they're halfway between
their housing on campus and getting back to their family.
And they're not sure what to do, you know, traveling wise.
They also may be finding themselves, you know, needing resources for food.
So we have made sure that we take full advantage
of the Resources For Living contact.
We also have, you know, the ability to refer them to the assistance plan
where they can speak with a counselor.
We've made heavy use of this when it comes to, you know,
stress related to the pandemic.
And, you know, kind of what's going to happen going forward,
you know, family members that have had COVID-19
and their home environment is very, very stressful.
There's a lot of different things that RFL provides
and again we tap into that and make sure that we share that information with the students.
Many of them are community resources [inaudible].
That really is all that we have for you today.
We will be sending out a link to a recording of the event shortly.
You'll be able to relisten and share that with colleagues.
There will also be contact information for any questions that you may have
about today’s topic.
We want to make sure that if afterwards you start thinking about
the webinar today and have additional questions or concerns
that you have the opportunity to share those with us.
At this point in time I'd like to say that I hope everyone will stay well and safe
and we’d all like to thank you so much for attending our COVID-19 webinar
"The Path Back to Campus".
Thank you and have a great day.
