E. Lessons Learned and Best Practices
VII. Data Tables
Final Survey Results in Table Format12
The tables in this section present the responses of the plans to the specific survey questions. For each question we present the number of health plans that responded to the question. Again, not all survey participants responded to all of the questions due to the built-in skip patterns and general non-response to a specific question. The tables include the data stratified as outlined below.
• number of plans that selected a particular response option (N)
• share of plans that chose that option relative to all plans that responded to this survey question (Share of plans, %)
• share of enrollment in plans that chose an option relative to the total enrollment in all plans that responded to the survey question (Share of enrollees, %)
• share of plans that chose an option relative to all plans of the similar size that responded to the survey question (Responses of plans by size, %)
• summary of open-ended responses and comments for each question
Note: to protect the confidentiality of the health plans' responses in cases where less than 3 plans chose a specific response choice, we did not provide the exact enrollment in those plans. Instead the "NA" answer was produced.
Questions 1 through 4 collected the contact information of respondents, specifically health plan name, submitter’s name, submitter’s position, submitter’s email address. The data from these questions are not presented in the report in order to protect the confidentiality of health plans’
responses.
12 The description of the plan groups (national, large, medium, and small) can be found on pages 12-15.
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5. Does your organization develop plans based on business interruptions that result from Loss or severe impact to critical
infrastructure (facilities, emergency power generators etc.)
84 97.7 100 (99.99) 190.6
Loss of technical infrastructure (e.g., IT software, hardware, platforms, redundant technology, etc.)
86 100.0 100 190.6
Loss of human resources (e.g. staff,
leadership) 73 84.9 96.9 184.7
Loss of communication networks 81 94.2 92.5 176.3
Responses of plans by size, %
Response options National,
n=8 Loss or severe impact to critical infrastructure
(facilities, emergency power generators etc.) 100 100 100 93.8 Loss of technical infrastructure (e.g., IT software,
hardware, platforms, redundant technology, etc.) 100 100 100 100 Loss of human resources (e.g. staff, leadership) 100 89.5 85.2 78.1
Loss of communication networks 87.5 100 92.6 93.8
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6. Please indicate if your organization has an incident command structure for an emergency response and recovery operation. (Select all that apply) (n=86)
Response options Formal Incident Command Structure that
aligns with the FEMA National Incident Management Structure (NIMS) Guidelines
32 37.2 37.9 72.2
Executive Leader that serves in an incident
commander or leader role 61 70.9 81.1 154.6
Disaster/Emergency Response Team(s) with defined responsibilities (e.g.
leadership, communications, logistics, operations, etc.)
73 84.9 93.3 177.8
Disaster/Emergency Manager with defined
responsibilities 62 72.1 93.0 177.3
Disaster/Recovery Team with defined
responsibilities 70 81.3 94.5 180.1
No, we do not have an incident command
structure 0 0 0 0.0
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Responses of plans by size, %
Response options National,
n=8 Formal Incident Command Structure that aligns with
the FEMA National Incident Management Structure (NIMS) Guidelines
37.5 47.4 37.0 31.3
Executive Leader that serves in an incident
commander or leader role 75.0 78.9 74.1 62.5
Disaster/Emergency Response Team(s) with defined responsibilities (e.g. leadership, communications, logistics, operations, etc.)
87.5 94.7 88.9 75.0
Disaster/Emergency Manager with defined
responsibilities 87.5 100 74.1 50.0
Disaster/Recovery Team with defined
responsibilities 87.5 100 96.3 56.3
Business Continuity Team 87.5 100 88.9 65.6
Emergency Operations Center (EOC)/Central
Command Center 87.5 84.2 63.0 34.4
Emergency Call Center 50.0 57.9 29.6 34.4
Other 12.5 10.5 3.7 6.3
No, we do not have an incident command structure 0 5.3 0 3.1
7. Have you performed a risk assessment to identify possible threats and their potential impact on the work of your organization? (n=86)
Response options N
Share of
Responses of plans by size, %
Response options National,
n=8
8. How often is your risk assessment to identify possible threats to the work of your organization updated? (n=76)
Response options N Share of
Responses of plans by size, %
Response Options National,
n=8
9. Has your organization conducted a Business Impact Analysis (BIA)? Note: the purpose of the BIA is to determine critical operations functions and processes and Recovery Time
Objectives (RTOs) for each process. (n=86)
Response options
Responses of plans by size, %
Response options National,
n=8
10. Does your organization conduct a periodic audit of business continuity planning?
(n=86)
Responses of plans by size, %
Response options National,
n=8
11. Has your organization established metrics (e.g., benchmarks) to evaluate your
emergency response/recovery/business continuity planning and operations? (Check all that apply) (n=86)
Responses of plans by size, %
Response options National, n=8
Yes, percent of operations restored 37.5 31.6 29.6 21.9
We have not established such metrics 25.0 26.3 37.0 56.3
Yes, other metrics (please specify) 12.5 26.3 7.4 6.3
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12. Do you have an established plan for communicating about changes in operations within 24 hours of an emergency with the following stakeholders during/after a disaster? (Check all that apply) (n=85)
Response options
N Share of plans, %
Share of enrollees, %
Number of enrollees,
million
Members 69 81.2 96.5 183.7
Customers/employer groups 66 77.6 97.1 184.8
Providers 67 78.8 94.7 180.3
Hospitals 55 64.7 88.7 168.9
Vendors/suppliers 58 68.2 94.4 179.7
Regulators 63 74.1 94.6 180.1
Public health officials 43 50.6 69.9 133.1
Local and state hospital associations 24 28.2 54.5 103.8
Local and state medical societies 15 17.6 47.6 90.6
News media 59 69.4 95.5 181.8
Leadership (e.g., CEO, Board of Directors, etc.)
77 90.6 95.0 180.9
Currently, we do not have an established plan for such communicating
4 4.7 0.1 0.2
Other 9 10.6 4.8 9.1
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Responses of plans by size, %
Response options National,
n=8
Customers/employer groups 100 94.7 80.8 59.4
Providers 100 89.5 76.9 68.8
Hospitals 100 63.2 61.5 59.4
Vendors/suppliers 100 89.5 73.1 43.8
Regulators 100 84.2 73.1 62.5
Public health officials 75.0 57.9 53.8 37.5
Local and state hospital associations 50.0 26.3 30.8 21.9
Local and state medical societies 37.5 21.1 19.2 9.4
News media 100 89.5 76.9 43.8
Leadership (e.g., CEO, Board of Directors, etc.) 87.5 100 96.2 81.3 Currently, we do not have an established plan for
such communicating 0 0 0 12.5
Other 0 15.8 11.5 9.4
13. Do you have policies/plans in place for your organization’s employees regarding any of the following support services during a disaster? (Check all that apply) (n=85)
Response options
Mental and behavioral health resources 42 49.4 88.1 167.7
No policies or plans currently in place 9 10.6 2.6 4.9
Other 3 3.5 NA NA
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Responses of plans by size, %
Response options National, n=8
Mental and behavioral health resources 100 68.4 46.2 28.1
No policies or plans currently in place 0 5.3 7.7 18.8
Other 0 10.5 3.8 0
14. Does your organization routinely conduct internal emergency preparedness drills and exercises? (n=85)
Responses of plans by size, %
Response Options National,
n=8
15. Which of the following emergency preparedness activities does your organization routinely conduct? (Check all that apply) (n=86)
Response options
Department “walk through” of their completed plans
43 50.0 90.4 172.3
Department /Division level table top exercises 39 45.3 88.1 167.9 Enterprise level multifunctional table top
exercises
37 43.0 83.3 158.8
Department/division simulation 19 22.1 60.5 115.3
Enterprise level multi-functional simulation 20 23.3 50.5 96.3
Technical infrastructure and data testing 63 73.3 91.5 174.4
Other 7 8.1 22.4 42.7
Responses of plans by size, %
Response options National,
n=8
Department “walk through” of their completed plans 100 73.7 55.6 18.8 Department /Division level table top exercises 100 63.2 44.4 21.9 Enterprise level multifunctional table top exercises 87.5 68.4 33.3 25.0
Department/division simulation 75.0 10.5 25.9 15.6
Enterprise level multi-functional simulation 75.0 15.8 18.5 18.8
Technical infrastructure and data testing 87.5 89.5 77.8 56.3
Other 12.5 21.1 7.4 0
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16. Please describe reasons for your plan not conducting internal emergency preparedness drills and exercises. (Check all that apply) (n=15)
Response options Prioritization (other activities take
higher priority)
9 60.0 23.2 1.3
Limited resources (e.g., limited staffing)
8 53.3 34.7 2.0
Other 4 26.7 46.8 2.7
Responses of plans by size, %
Response Options National,
n=0
Prioritization (other activities take higher priority) NA 0 100 63.6
Limited resources (e.g., limited staffing) NA 50.0 0 63.6
Other NA 50.0 0 27.3
17. The U.S. Department of Homeland (DHS) Homeland Security Information Network Healthcare and Public Health Sector Portal (HSIN-HPH) facilitates secure voluntary two-way sharing of information with the Federal Government on emergency preparedness and response issues. Additional information and access can be requested by emailing
[email protected]. Is anyone from your organization registered on the HSIN-HPH? (n=86)
Response options N Share of
Responses of plans by size, %
Response Options National, n=8 Large, n=19
18. What information/training/resources from local, state, or federal public health officials could make your disaster planning efforts and recovery operations more successful?
(Check all that apply) (n=86)
Planning for internal health plans operations
Response options
Inclusion in drills or simulations 54 62.8 63.0 120.1
Lists of emergency contacts 67 77.9 56.3 107.3
Ongoing updates as situation evolves 69 80.2 82.6 157.4
Webinars 57 66.3 57.5 109.6
Other (please describe below) 4 4.7 17.1 33.0
No information needed 3 3.5 NA NA
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Responses of plans by size, %
Response options National,
n=8
Inclusion in drills or simulations 62.5 94.7 55.6 50.0
Lists of emergency contacts 50.0 84.2 88.5 78.1
Ongoing updates as situation evolves 75.0 94.7 40.4 81.3
Webinars 62.5 68.4 63.0 68.8
Other (please describe below) 25.0 5.3 0 3.1
No information needed 0 0 11.1 0
Planning for member-related activities
Response options
Ongoing updates as situation evolves 61 70.9 74.0 141.0
Webinars 43 50.0 48.0 91.5
Other (please describe below) 6 7.0 35.8 68.2
No information needed 3 3.5 NA NA
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Responses of plans by size, %
Response options National,
n=8
Inclusion in drills or simulations 50.0 63.2 48.1 25.0
Lists of emergency contacts 50.0 63.2 55.6 43.8
Ongoing updates as situation evolves 62.5 89.5 66.7 65.6
Webinars 50.0 52.6 48.1 50.0
Other (please describe below) 37.5 10.5 0 3.1
No information needed 0 0 11.1 0
19. If you checked the option “Other” in the previous question, please describe.
20. What would trigger a review of possible temporary changes in benefits because of an adverse event? (Check all that apply) (n=85)
Response options
Federal declaration of emergency 82 96.5 99.8 189.7
State declaration of emergency 81 95.2 88.8 168.8
Other (e.g., corporate policy) 28 32.9 67.5 128.3
Responses of plans by size, %
Response options National, n=8
Federal declaration of emergency 100.0 100 100 90.6
State declaration of emergency 87.5 94.7 100 93.8
Other (e.g., corporate policy) 62.5 52.6 23.1 21.9
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21. In the event of a disaster what temporary changes to your regular policies would you consider (as appropriate to the situation)? (Check all that apply) (n=85)
Response options Revision or relaxation of out-of-network
restrictions
70 82.4 83.7 159.1
Ensuring the availability of electronic medical records to facilitate the continuity of care
34 40.0 41.1 78.1
Establishing a toll-free help line 61 71.8 69.1 131.3
Establishing emergency assistance on your web site
58 68.2 85.7 162.9
Extending time periods for filing claims 72 84.7 86.0 163.5
Process to accept incomplete claims due to record or data loss
43 50.6 41.4 78.7
Temporarily suspending of provider precertification requirements (e.g.
credentialing, etc.)
53 62.4 48.5 92.2
Temporarily suspending of business rules for pharmacy re-fill limitations
65 76.5 84.9 161.4
Temporarily suspending durable medical equipment replacement limitations (e.g.
electric wheelchairs, O2 concentrators, etc.)
57 67.1 79.9 151.9
Temporarily suspending of business rules for pre-certification
52 61.2 82.1 156.1
Temporarily suspending of business rules for prior medical authorization
60 70.6 84.5 160.6
None of these options 1 1.2 NA NA
Other 12 14.1 32.7 62.2
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Responses of plans by size, %
Response options National, n=8 Revision or relaxation of out-of-network restrictions 75.0 73.7 80.8 90.6 Ensuring the availability of electronic medical
records to facilitate the continuity of care 62.5 42.1 26.9 43.8
Establishing a toll-free help line 75.0 68.4 80.8 65.6
Establishing emergency assistance on your web site 87.5 68.4 69.2 62.5
Extending time periods for filing claims 75.0 89.5 88.5 81.3
Process to accept incomplete claims due to record or
data loss 50.0 63.2 46.2 46.9
Temporarily suspending of provider precertification
requirements (e.g. credentialing, etc.) 50.0 84.2 61.5 53.1
Temporarily suspending of business rules for
pharmacy re-fill limitations 75.0 89.5 73.1 71.9
Temporarily suspending durable medical equipment replacement limitations (e.g. electric wheelchairs, O2 concentrators, etc.)
75.0 73.7 61.5 65.6
Temporarily suspending of business rules for
pre-certification 75.0 84.2 57.7 46.9
Temporarily suspending of business rules for prior
medical authorization 75.0 89.5 69.2 59.4
None of these options 0 0 3.8 0
Other 37.5 15.8 11.5 9.4
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22. Do you have specific policies and capabilities that allow you in the event of emergency to identify and provide necessary assistance to the following populations? (Check all that apply) (n=84) Yes, for durable medical equipment dependent
members (e.g. electric wheelchairs, O2 concentrators)
29 34.5 67.5 127.9
Yes, for prescription drugs dependent members (e.g.
insulin, methadone, etc.)
39 45.4 73.3 138.9
Yes, for at-risk populations who are dependent on home health care
30 35.7 68.0 128.9
No, we do not have policies and capabilities to identify and provide necessary assistance to these populations in the event of emergency
34 40.5 14.5 27.5
Other 10 11.9 13.0 24.6
Responses of plans by size, %
Response options National,
n=8 Yes, for durable medical equipment dependent members
(e.g. electric wheelchairs, O2 concentrators) 75.0 31.6 28.0 31.3 Yes, for prescription drugs dependent members (e.g.
insulin, methadone, etc.) 75.0 52.6 40.0 40.6
Yes, for at-risk populations who are dependent on home
health care 75.0 31.6 32.0 31.3
No, we do not have policies and capabilities to identify and provide necessary assistance to these populations in the event of emergency
0 36.8 44.0 50.0
Other 25.0 15.8 16.0 3.1
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23. In the event the U.S. government provides a non-formulary drug (e.g. antivirals) would your health plan consider covering the pharmacy dispensing fee? (n=84)
Response options
Responses of plans by size, %
Response options National,
n=8
24. In the event of emergency do you have the capabilities to use claims data to anticipate and monitor the following potential needs regarding the continuity of care: (n=84)
Response options Access (e.g. healthcare providers,
facilities)
66 78.6 94.4 179.4
Utilization (e.g. providers, services) 74 88.1 96.9 184.1
Pharmacy medications 76 90.5 97.0 184.3
Durable medical equipment 65 77.4 93.5 177.7
Patient safety 41 48.8 60.5 115.0
Quality of care 52 61.9 70.2 133.4
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Responses of plans by size, %
Response options National, n=8 Access (e.g. healthcare providers, facilities) 100 84.2 76.9 71.0
Utilization (e.g. providers, services) 100 94.7 84.6 83.9
Pharmacy medications 100 94.7 84.6 90.3
Durable medical equipment 100 84.2 73.1 71.0
Patient safety 75.0 52.6 46.2 41.9
Quality of care 87.5 57.9 46.2 71.0
25. In the event of emergency do you have the capabilities to use data from nurse call lines to monitor possible problems with the following: (n=84)
Response options Access (e.g. healthcare providers,
facilities)
61 72.6 90.0 171.0
Utilization (e.g. providers, services) 60 71.4 88.6 168.3
Pharmacy medications 58 69.1 84.7 160.9
Durable medical equipment 51 60.7 81.3 154.5
Patient safety 48 57.1 57.2 108.7
Quality of care 53 63.1 64.2 122.0
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Responses of plans by size, %
Response options National,
n=8 Access (e.g. healthcare providers, facilities) 100 73.7 61.5 74.2
Utilization (e.g. providers, services) 100 73.7 57.7 74.2
Pharmacy medications 87.5 73.7 57.7 71.0
Durable medical equipment 87.5 63.2 53.9 58.1
Patient safety 62.5 57.9 53.9 58.1
Quality of care 75.0 57.9 53.9 70.1
26. Are there contingencies in place to expand the following services to accommodate a surge in calls in the event of a disaster? (n=84)
Distribution of “Yes” responses
Response options
Responses of plans by size, %
Response options National, n=8
27. Do you have a process in place for provisional/emergency credentialing of providers?
Responses of plans by size, %
Response options National, n=8
28. In your experience, are there legal or regulatory barriers in place that hinder making changes in your business practices and policies during or after a disaster? (n=84)
Distribution of “Yes” responses
Response options
Federal legal or regulatory barriers 32 38.1 59.0 112.1
State legal or regulatory barriers 36 42.9 58.6 111.3
Local legal or regulatory barriers 12 14.3 26.0 49.4
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Responses of plans by size, %
Response options National, n=8
Federal legal or regulatory barriers 50.0 42.1 34.6 35.5
State legal or regulatory barriers 50.0 36.8 46.2 41.9
Local legal or regulatory barriers 25.0 10.5 15.4 9.7
Relationship with Other Health Care Stakeholders and Public Health Entities – National, State and Local
29. Do you share with emergency officials (e.g. state or local public health officials) any information on your contingency plans? (n=83)
Response options
Responses of plans by size, %
Response options National, n=8
30. Is it clear to you whom to call or notify within regulatory agencies in the event of a disaster or a public health emergency? (n=83)
Distribution of “Yes” responses
Response options
Responses of plans by size, %
Response options National, n=8
31. How often do you update the list of emergency contacts with federal, state, local agencies and government? (n=83)
We do not maintain a formal list of
emergency contacts 10 12.0 7.4
14.0
Other 4 4.8 12.0 22.8
60
Responses of plans by size, %
Response Options National,
n=8
We do not maintain a formal list of emergency
contacts 12.5 10.5 11.5 13.3
Other 25.0 5.3 3.8 0
32. Does your organization routinely participate in external (national, state or local) emergency preparedness drills and exercises? (n=83)
Response options
Responses of plans by size, %
Response Options National,
n=8
33. How often does your organization participate in external emergency preparedness drills and exercises? (n=25)
Responses for national drills
Response options
Responses for state drills
Response options
Responses for local drills
Response options
Responses of plans by size, % for national drills
Response options National, n=4
Responses of plans by size, % for state drills
Response options National, n=4
Responses of plans by size, % for local drills
Response options National, n=4
34. Please describe reasons for your plan’s not participating in external emergency preparedness drills and exercises. (Check all that apply) (n=58)
Response options
No opportunities to participate 33 56.9 47.9 60.7
Limited resources (e.g., limited staffing etc.)
31 53.4 45.8 58.1
Other 9 15.5 43.0 54.5
Responses of plans by size, %
Response options National, n=4
No opportunities to participate 50.0 46.2 61.9 60.0
Limited resources (e.g., limited staffing etc.) 75.0 23.1 57.1 65.0
Other 25.0 30.8 9.5 5.0
Lessons Learned and Best Practices
35. Is your organization interested in participating in a forum to share best practices and lessons learned? (n=83)
Responses of plans by size, %
Response options National, n=8
36. Are there lessons learned from past experiences your organization would like to share?
(n=83)
Responses of plans by size, %
Response options National, n=8
37. Are there disaster preparedness and response best practices that you would like to share? (If you want to share any documents, describing your disaster preparedness and response activities, you can send them to [email protected]) (n=83)
Response options N Share of
Responses of plans by size, %
Response options National,
n=8
Thank you for your participation in the National Survey of Health Insurance Plan Emergency Preparedness, an initiative AHIP is doing in partnership with public health leaders to assess the level of readiness and ability of health insurance plans to restore operations in a timely manner during and after an adverse event. Adverse events may include a natural or man-made event, such as a public health emergency, pandemic, weather disaster, cyber threat, terrorism, or other local or national emergency that impacts operations. The goal of the assessment is to identify areas where government and public health entities can assist health plans, and capture and report
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