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Remote workforces and virtual infrastructures may be healthcare's future, especially for payers

COVID-19 has made working from home more attractive, and healthcare could use this trend to its financial advantage.

Jeff Lagasse, Associate Editor

As with many other industries, healthcare is the subject of speculation as to what permanent changes may result from the response to the still-raging COVID-19 pandemic. Analyses, commentaries and academic studies have told us a few things: that telehealth capabilities will likely remain more robust, that sanitation protocols at hospitals will remain more thorough than they have been in the past, and that patients may need time to overcome their trepidation about seeking in-person care.

One trend in particular may impact a large portion of the healthcare workforce: working remotely.

The businesses that have managed to function with minimal interruption during the public health crisis have done so in large part by allowing their staff to work from home. Offices are dark as employees log into work on their laptops and conduct business mere feet from where they live and sleep. And now that these home-based employees have had an extended run in their makeshift offices and workspaces, more and more are starting to like it. Fewer and fewer may go back.

At first glance, it doesn't seem as though the healthcare industry is primed for a widespread migration to the home. Doctors, nurses, specialists and many other staff can only do their jobs within a hospital's walls, after all. Appendectomies can't be performed virtually, and many patients lack access to Internet connections altogether, a rapidly emerging social determinant of health.

But support and administrative staff, health plans, insurers, and other nonclinical healthcare positions can be readily transitioned to home settings. While this has the obvious advantage of helping to curb the spread of COVID-19, it also represents an opportunity for organizations to save on real estate, equipment and infrastructure costs – which will be particularly important as businesses pinch pennies in their coronavirus recovery efforts.

"I've never believed in brick-and-mortar," said Deb Mabari, CEO of CODY, a healthcare technology and consulting firm that has been virtual since its inception in 2006. "I'd be driving to work an hour each way. In my opinion that's a complete and total waste of time."

While remote work capabilities can be extended to nonclinical staff, health plans – specifically the ones that serve Medicare, Medicaid and commercial markets – stand to benefit the most, in part because they can expand their talent pool by hiring nationally.

"If you're able to recruit talent across the country without having them relocate to your location, and worry about uprooting families and kids, etc., think of the pool of people and the talent you could have," said Mabari. "It becomes exponential.

"In my business, this pool of talent is very small," she said. "People who understand Medicare and Medicaid … less than 1% of the population really understand it. We were forced to create a virtual environment. It saves money on leases, equipment, furniture. This way, we're in a situation where we're taking the money we're saving and putting it into generous benefits packages for employees."

Of course, if an organization works remotely, that likely means that interviews to fill positions will occur remotely as well. According to Mabari, there are certain traits and skills that hirers should be on the watch for. Ensuing that employees can work well in a home environment is a consideration that's necessary if a business elects to forgo physical space in favor of cyberspace.


First and foremost, a job candidate should be self-motivated and have solid time management skills, along with at least a touch of entrepreneurial spirit. That's important whether the position is virtual or not.

For remote hires, Mabari recommends conducting interviews over the phone rather than via Zoom or other video streaming services.

"We really try to listen to how people sound over the phone," she said. "We refer to this as appearance discrimination. If the job is virtual, you're going to be on the phone a lot with other people. How they're interacting with you on the phone, and your cadence back and forth, can be very telling."

When on the phone with a potential hire, it can also be important to ask what Mabari calls "behavioral interview questions." This means avoiding the typical fare such as "What are your strengths and weaknesses?" and instead asking open-ended questions – not seeking the answer they want, but instead asking something tied to the experience on the applicant's resume.

For example, an applicant who's a parent may have children they walk to the bus stop in the morning. If the candidate brings this up, rather than asking if they would prefer working slightly earlier or later to meet this parental obligation, an interviewer can instead ask how having children at home might affect their virtual office setup, or how they would make up the time lost waiting for the school bus.

What works for one person may not work for another. Since work-from-home jobs tend to be more flexible, the answers to such questions can help the hirer develop a more complete profile of the candidate they're considering.

Attracting talent in the first place is a necessary component to any hiring strategy. In healthcare especially, it's useful to have a strong online presence. Leveraging social media such as LinkedIn is common in the managed care space, but the single biggest factor in terms of online reputation is the company website.

"People will go to your website first and foremost," said Mabari. "They want to see news, white papers, things that you have out there that show your expertise in the marketplace and how you're positioned, because everybody wants to be on the winning team."

Businesses also need an appropriate organizational structure if they're planning to go virtual. That means appropriate time management processes, appropriate billing and an integrated accounting system, an established communication workflow, and disaster recovery with multiple locations. 

It's a lot to consider, but Mabari expects that payers will increasingly embrace the virtual model as the pandemic calcifies certain societal changes.

"You're going to see a lot more of these payers having a smaller presence versus larger health plans that have big buildings and corporate offices," she said. "You're going to see a smaller version of that, and people will be moving virtually – and it will create opportunities for people across the United States."

Twitter: @JELagasse
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