Methodological proposal to deal the COVID-19 Pandemic from the Insurer’s perspective

Abstract

Objective: To present a methodology for implementing strategies to face the COVID-19 pandemic as recommendations, following the guidelines and regulations in force in Colombia and from the insurer’s experience.
Methods: It is divided into three phases: a planning phase, which includes population characterization activities, definition of methods and projections of service frequencies; a development phase, which involves all the activities, routes, protocols and flow charts to be developed in order to attend the affiliated population in a timely and quality manner; finally, an evaluation phase, in which indicators are defined, adjustments are made to the frequencies of services based on what has been observed, and care strategies are supplemented for the rest of the population, with priority in older adults, maternal and risk pathology.
Results: In the three phases of the contingency plan against COVID-19 (planning, development and evaluation), fundamental tasks were identified to achieve both the health results and the cost-effectiveness levels expected by the Organization. Among those that stood out the most were the Characterization of the Population to identify the risks and mitigate them within the development phase, the projections of frequencies of services and costs, the elaboration of attention protocols and the measurement by means of tracer indicators.
Conclusions: Joint strategies between the actors involved are the key to optimizing the finite resources of the Health System and proposing methodologies that can positively impact both individual and collective health results.