Interview: Dr Damian Cornacchia and Lynn Pina, GeoBlue

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Senior Medical Director Dr Damian Cornacchia and Chief Marketing Officer Lynn Pina speak to Chloe Fox about GeoBlue, its role within the medical insurance industry and what lies ahead for the company

Having worked in various roles across the medical industry, why did you choose to move into international healthcare?

Dr Damian Cornacchia: After deciding that I wanted to transition from the bedside, like many physicians, I investigated pharmaceutical and domestic health insurance opportunities. I happened to come across GeoBlue’s job listing online for a Medical Director. The name grabbed me immediately. My interest began to grow, realising that dealing in the international arena would be significantly more interesting than just the domestic side. Then, discovering that I would also be involved in helping to manage healthcare delivery as well as evacuations abroad made it that much better. Working with the international healthcare community is very rewarding as well as a challenge at times. Although not ‘hands-on’, I feel our company has more than just a financial impact on our members as we help them obtain quality healthcare abroad.

As Chief Medical Director at GeoBlue, what are your key responsibilities?

DC: In conjunction with our Clinical Services Director, I have oversight of the medical directors and the medical review team. In addition to working cases, approvals, denials, appeals, evacuations, repatriations, and monitoring the care on live cases, I also serve on multiple committees and participate in projects. We have become URAC accredited for health utilisation management and were recently awarded the contract to manage the Overseas Assistance Center for the Blue Cross and Blue Shield Federal Employee Program (FEP). I’ve participated in projects such as these, serving as a subject matter expert from the clinical side. Additionally, I have clinical oversight of the quality metrics we use to measure the performance of the clinical team. I also work with departments such as underwriting and compliance to supply clinical input where needed. I also participate in guest lecturing, presentations to potential clients, and working with domestic medical directors on mutual cases.

How do you choose the medical partners you work with, and why are these relationships so vital?

DC: GeoBlue has a unique network of regional physician advisers (RPAs), trusted doctors in almost every country who are experts on local standards of care. These are physicians chosen for their credentials and medical expertise, but most importantly their local knowledge of the country or region they practise in. Our global networks team consults these doctors when recruiting new providers, and they offer insight and their professional opinions on candidates for inclusion into our network. Our RPAs know what our members look for, and they factor in those needs in their feedback. By working closely with our RPAs, we can ensure that we have an accurate picture of potential network providers and that we maintain a network of providers who will deliver the excellent care that our members expect. Our RPAs may also become involved in a particular case by being a liaison between us and the treating clinicians. In addition, GeoBlue has a thorough process for identifying and vetting providers to join our contracted provider network.

With a huge increase in the number of remote workers, digital nomads, and expats, how has GeoBlue’s telehealth offering changed, if at all?

Lynn Pina: GeoBlue’s telehealth offering was always designed with this audience in mind, given the nature of our business and the members we serve. What has evolved for us is a deeper, more proactive integration of telehealth into the member journey. We promote telehealth across several member touch points, including our portal, mobile app, member communications, on explanations of benefits (EOBs), in member materials, as well as leveraging our frontline service teams to proactively educate, remind and encourage our members to avail themselves of these services. Because of this, we have a very high utilisation of telehealth among members.

How have the geopolitical challenges of recent years, such as the Covid-19 pandemic and the current conflicts around the world, affected how you operate?

LP: Covid-19 presented challenges that could not have been predicted and that had never been experienced prior. From figuring out how to conduct medical evacuations in a world with closed borders and countries under quarantine to having to adjust our protocols and policy language, we were able to quickly pivot to support our members during a worldwide pandemic.

During Covid-19 and since, we have implemented processes to more closely monitor the opening and closing of facilities which before now had largely been unheard of. We also developed and leveraged alternatives to care through established telehealth providers and/or allowed members to have virtual care calls with their existing providers should the need arise. A particular area of focus has been on mental health programmes given the increased concerns during and post-Covid. From an operational perspective, our company moved to a hybrid work model, so our staff is more dispersed, and we leverage tools and technologies that allow us to effectively work around the clock servicing members everywhere in the world.

On the matter of geopolitical challenges, we continue to work closely with our security partners to support our members who are affected by political disruptions and military conflicts, whether temporary or long-term in nature. Our members who have this service as part of their programme have real-time access to actionable information on their smartphones, including up-to-the-minute safety and security recommendations, and air and ground transport conditions. We are also able to support members who find themselves in a situation requiring evacuation due to political unrest and/or a natural disaster.

How can efficient international travel medical plans benefit global populations?

LP: Global travel medical plans and the services provided by a global medical insurer are specifically designed to support the globally mobile. This includes 24/7 operations, benefits incorporating services typically not found in domestic plans (e.g. doulas, ningen docks for Japanese nationals, medical evacuation, etc.) and coordination that an international insurer has both the expertise and the capabilities to effectively provide, as well as customised programmes like pre-departure assessments and global telehealth.

As an insurer serving US-based companies and travellers, our international travel medical plans take into consideration the fact that a US-style health plan can complicate the healthcare process and customer experience when used in other countries.

Deductibles, copays, and coinsurance are not common in many non-US countries and can complicate payment to the provider whereby providers may demand foreigners pay in full at point of service to ensure they are paid the full amount. This can result in maxing out a foreigner’s credit card if hospitalised.

Travel medical plans should assume 100% of the risk for claims. Global populations should also have medical evacuation and repatriation cover, which international travel medical plans offer but US domestic plans typically do not. Should a medically necessary evacuation be needed, not having the proper coverage can result in a significant financial and emotional burden on the individual. In addition to an international travel medical plan for global populations, a global service centre is necessary to handle calls coming from any time zone 24/7 and can provide a guarantee of payment and direct settlement, in addition to providing access to a global network of providers. A global service centre will also be able to accommodate multiple languages and handle multiple currencies for provider payments and claims reimbursement.

How have mobile and online tools benefited medical care abroad? Telehealth has become an invaluable asset to those travelling.

LP: Mobile and online tools have made it much more convenient for members to get timely, location-specific information related to their medical needs, as well as the ability to perform complex self-service functions. Some examples are outlined below, all of which are available in GeoBlue’s mobile app and member portal:

  • Access to telemedicine, video, or audio appointments anywhere in the world
  • Provider searches with door-to-door direction for multiple modes of transportation
  • Medicine equivalent databases, which help members know if their medications are available in other countries and what they are called
  • Translation tools, which allow members to communicate important medical information to others in multiple languages
  • Request guarantees of payment directly from their mobile device
  • Electronic ID cards
  • Claims submission tools.

What new technology is next for GeoBlue?

LP: We are continually looking for ways to make direct improvements to the customer proposition, expand the markets we serve, and improve the way we work to enhance what we deliver to our customers. We know that healthcare is more than just plan designs and processing claims.

Over the past five years, we have invested heavily in our technology and improvements to our overall customer experience, from harnessing the transformative potential of artificial intelligence (AI) to cutting-edge data analytics technology to offer services with new levels of personalisation.

We are also building new technology around service, care management, disease management, and overall wellbeing, streamlining communication, collaboration, and information-sharing across the entire healthcare ecosystem, and especially with our customers. We will also be introducing new capabilities for predictive analytics and personalised insights into our care management processes.

Finally, we regularly improve our mobile app with enhancements, which have included a new mobile responsive design; expansion of translation capabilities; improved claims form language; electronic claims form traceability; addition of voice integration on some text entry fields; and easy accessibility to news alerts. Our mobile app consistently receives positive member feedback about its usability and intuitive functions.