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Jeremie Poplin:

Dr. Cunningham, thank you so much for joining us this morning. How are you, sir?

Joseph R. Cunningham, M.D.:

Oh, I'm doing fine. Jeremy, I appreciate the opportunity to talk to you and your listeners and hope you and everybody else is doing well.

Jeremie Poplin:

We are a bit antsy at times as I think most of us are during this during this period of time. But that is to be expected. Before we dive in just from the Blue Cross Blue Shield perspective, since you are a doctor, I just wanted to get your perspective on what's happening around the state during this COVID -19 pandemic. The state department, you know, Oklahoma has confirmed over 2,000 cases. So we're still trying to stress that everyone wants to go back to work, but there are still policies and things we have to implement in our day to day lives to make sure that we're still healthy and trying to protect ourselves for the future.

Joseph R. Cunningham, M.D.:

You know, you're exactly right that this crisis and I do see it as a crisis, has created difficulties for all Oklahomans and really for all Americans. But from staying at home to changing our behavior to look differently as we gather or don't gather with groups. And so it's caused such a hardship on everyone. And as a physician, you know, I, I'm concerned about people that need health care, being able to access it. I'm concerned about providers and their ability to stay healthy, healthy while helping others. And so we've tried to do as much as humanly possible at Blue Cross to make that transition to these unsettling times as easy as possible.

Jeremie Poplin:

You know, the thing that stands out to me, Dr. Cunningham, is you hear things like continue to wash your hands, try not to touch your face, nose, eyes and mouth. I feel like moving forward practices like this, maybe this has put more emphasis on things like that. That really doesn't sound like a bad thing to me at all about general practices moving forward even when we're out of the pandemic.

Joseph R. Cunningham, M.D.:

Oh, exactly right. I mean, you know, it is a little unsettling to think that we have to change some of our behaviors like handshakes or, or how we greet and interact with people. But the fact is that more handwashing trying to keep our hands off of our face, be careful when we touch things to wash afterwards. These are all good things that will come out of this pandemic.

Jeremie Poplin:

Staying a home is difficult for a lot of people, but it's also key to try to keep this as low as possible, to not try to overwhelm our medical professionals and facilities. We've seemingly done a pretty good job of that here in this state, Dr. Cunningham, because the numbers here are vastly different than we're seeing in other selected pockets of our country.

Joseph R. Cunningham, M.D.:

You're exactly right. But you know, as we get deeper and deeper into this pandemic, we see that things are going to center around testing. And we knew that early on. That's why we decided to basically, any network lab or office that was applying CDC guidelines for testing, we wanted to make it as simple as possible. So we applied no cost share to patients. We wanted to do whatever it could to get those that needed to be tested, tested. As we look forward to how we get back to some semblance of normal, we also know that testing is critical. We actually have some calls with the state department of health to see how we can partner with them to get testing out into more of the rural areas as well. We — I'm not sure we have a full grasp on the prevalence in rural Oklahoma just because of the lack of testing.

Jeremie Poplin:

I went on the air last week and was talking about Blue Cross Blue Shield here in this state because that was one of the first companies that I saw that really stepped forward during this time. So maybe you could kind of walk me through what your conversations were like when you first started to see what was going on here in the state and why you wanted to act so quickly to make sure that, that your customers were protected during this time.

Joseph R. Cunningham, M.D.:

Well, we knew that, that we needed to change the health care delivery model very rapidly. And so we wanted to remove any barriers that existed to this change. And we would rather overshoot what we do during this time. We can always bring it back. And what we look at is we've always had telehealth or telemedicine benefits for our membership. However, the utilization was always very, very low. People were used to just from the historic practices of going into the office to see their doctor and to receive care going into the emergency room when they had doubts. And we needed to try to do our part to try to change or shift this delivery model. So we — what we did is we worked with the insurance department and the governor's office to remove temporarily some of the state statutes. So we could allow providers that weren't necessarily set up to deliver telemedicine to deliver it in a much more expeditious way using telephone and some of the new technologies on Facebook and other things. We did that. We tried to remove all barriers by making no copay for members on these visits. So, and then the last thing is we want to protect the physicians, the medical professionals that are delivering care, and we know that they're small businesses just like everybody else. So we equalize the pay for these telemedicine visits so that now it's, it's basically equal to a face to face office visit.

Jeremie Poplin:

What has the reaction been with the, with the telemedicine? I've, I've known several people that have had to use it during this time. There are some that, you know, aren't used to it yet and to be expected with use of technology, but for the most part I've heard pretty positive things moving forward. What have the reactions been that you've heard?

Joseph R. Cunningham, M.D.:

Oh, exactly the same. Doctors that have been in practice for decades are taking it up very rapidly. Patient populations are taking it up. They're using technologies that they hadn't. I think the uptick was so rapid it shocked many of us that looked at this. Now I'm very happy that they're doing it because we need to keep people from congregating in a doctor's office where historically there's a lot of sick people. We need to try to keep them out of the emergency room if indeed it can be treated by a telehealth visit. You know, one of the other things I want to say is that we basically allowed these visits for behavioral health or what was in the past called mental health visits. Other things like intensive outpatient therapies in the behavioral health range and partial hospitalization programs. We wanted to do that because most studies are showing significant increases in behavioral health issues, and we want to do our part to try to get these people treatment as quickly as possible.

Jeremie Poplin:

You would be surprised though, we were talking off the air on Friday. You would be surprised about, you know, in some instances, you know, the clarity of the camera to be able to even diagnose just regular problems. There are some people that have been surprised just how accurate and that you can be with, with the quality of cameras that we have now right in our hands on our cell phones.

Joseph R. Cunningham, M.D.:

Oh, that's exactly right. And that's a great example. I was talking to a friend of mine who was telling me he was treating an eye infection by a telemedicine visit. And I was kind of asking how he did it. And he said, honestly, at his age, these cameras, the clarity is so sharp, it's really better than him looking face to face. And so he said just expanding their perspective on what they can do with telemedicine has been a significant improvement in the care that's being delivered.

Jeremie Poplin:

So for someone that, that might have some concerns that isn't used to it yet, what were some tips that you would give them that they've heard about telehealth but they haven't yet been able to use it yet? Are there a few tips that you could give them?

Joseph R. Cunningham, M.D.:

Yeah, I would say work with your provider and see what they're utilizing. They're all utilizing telephone and we all have phones. So you can start there. And based on what technologies the provider is using, they can walk them up to some of these FaceTimes and Facebooks and Skypes and things like that. And they're really relatively easy. And so I know that I've had these discussions with my own mother and she has been really remarkably accepting of this. So I think that just work with your doctor, work with your doctor's office, your provider's office to see what they do and they'll bring you along at a relatively rapid pace.

Jeremie Poplin:

Dr. Cunningham is with us from Blue Cross Blue Shield of Oklahoma. You have your Blue Cross Mobile Assistance Center or MAC team that's available to help people with any questions that they have. If someone has questions, how would they get in contact with, with the MAC team?

Joseph R. Cunningham, M.D.:

Okay. Yes. Well they basically, you can call the back of your card or you can go online and look at Blue Cross Blue Shield of Oklahoma and it will direct you our website will direct you how to reach the mobile assistance unit or mobile assistance centers that we have. These are housed by Oklahomans that understand what we're going through. They're all working out of their home currently. So basically it's Oklahomans taking care of Oklahomans.

Jeremie Poplin:

You've, you've been a doctor for a long time. What separates Blue Cross Blue Shield from everyone else? It seems to me that the company doesn't want to be self-serving. They're genuine and they're sensitive, especially during this time of the pandemic.

Joseph R. Cunningham, M.D.:

You know, I can honestly say I did practice, I practiced in Oklahoma for many years and the thing about Blue Cross that appeals to me, it allows me to do what it is I took an oath to do and that's to take care of patients to do no harm. And as a member-owned health insurance, we're not-for-profit. We really focus on what's best for our members. We have no shareholders. Our members own our company and so we do whatever is in their best interest regardless of the cost, if it's the best way to get or keep them healthy for the long term.

Jeremie Poplin:

And you want to make sure to let everyone know as well that there are, there are many options to try to obtain health care. And Blue Cross is always there to help, whether it's a qualifying life event, job loss baby or you've moved, there are ways for you to get health coverage through Blue Cross.

Joseph R. Cunningham, M.D.:

That's exactly right. You can go online and look, we are the only health insurance company in our state that, that has been on the exchange, the Affordable Care Act — what Oklahomans commonly call Obamacare — since its inception. It was very hard during the early years. We provide this option for everybody in all 77 counties. If you have a life changing event, you can go online or you can contact the mobile assistance center or any insurance broker that you may know across the state and they can help you obtain insurance. We're there, we have a plan that meets most everyone's needs. And it's a way to keep health insurance to protect families from the risk of financial ruin from the escalating health care costs that may be in their future.

Jeremie Poplin:

And Dr. Cunningham, we want to stress that Blue Cross Blue Shield of Oklahoma, you're helping members by covering the cost of the COVID-19 testing.

Joseph R. Cunningham, M.D.:

Yes sir. We cover the cost at no copays, no pay for the patients. We cover all telemedicine regardless of the diagnosis. All hospitalizations for COVID-19 were preauthorized — all those restrictions were removed. We also removed copays and deductibles for any COVID-19 related hospitalizations. That may not sound like a big deal, but as more and more people have high-deductible health plans in the four or five and six thousand dollar deductible range, and this is being early in the year, most people have not met their deductible. We waive that deductible if they're hospitalized for COVID-19

Jeremie Poplin:

It's funny because you say, you know, that may not seem like a big deal. That's a massive deal because we were talking about this last week when we first found and they got the news release about what Blue Cross Blue Shield was doing, of Oklahoma. And the first thing that I said was, we keep hearing this term unprecedented but, but what you guys have decided to do to help your members is unprecedented as well. We haven't really seen anything ever like this before.

Joseph R. Cunningham, M.D.:

We haven't, and you know, I talked about us being a member-owned insurance company, not having shareholders. We do what's right. We're doing what Oklahomans would want to do for fellow Oklahomans. And that's why waiving these deductibles, making testing available to everybody, opening up telehealth so people can still get care without increasing the odds that they encounter somebody with COVID-19. It's, it's what we're here to do. And it's what I'm proud to say that Blue Cross does.

Jeremie Poplin:

You know, through times we joked about this, but through times like this, like the telehealth, we use that as an example. Sometimes it takes that little nudge maybe forcing us to try to do something new that we stumbled upon actually something great. I think that this is probably the future moving forward for a lot of people in regards to the telehealth practices.

Joseph R. Cunningham, M.D.:

Absolutely. We see telehealth as it — and you know, I don't want to just say Blue Cross is the only one that's doing good things. There are a lot of not-for-profits that are on the front line doing things. We're trying to support them. There are two United Way COVID response funds that we're supporting in grants right now. One with the Tulsa community foundation and Tulsa area United Way and one with the United Way of Central Oklahoma because they are helping Oklahomans that are dealing with their needs related to food insecurity, elder care, childcare, and really even unemployment. And as we look forward, we've seen lots of small businesses having to close, lots of people to have to lay off some of their employees, even larger companies, some hospitals are having to furlough people. The other thing is we're trying to improve access to care and access to information. We're supporting the two Oklahoma 211 entities that basically have the statewide COVID-19 hotline. Because it's important that we get this information out. We need to be able to help people diagnose COVID-19. We need to help others treat the mental health needs of our community and some of the needs due to job loss. So we've supported the community service council and HeartLine OKC and their 211 efforts.

Jeremie Poplin:

There are pretty remarkable people that are in this state that are always willing to go take that extra step, you know, step out on the ledge and try to help people. And all of those that you just mentioned, we've talked with, with several of those on the show so far. And it never ceases to amaze me. I was born here and grew up here and spent virtually my entire life here and I'm always amazed at the extra links that people are willing to go. And I'm sure you've seen that same thing.

Joseph R. Cunningham, M.D.:

The ability for Oklahomans to help others is second to none. And I think it's shown in our philanthropy. We've known that this is a very philanthropic state, but also it's a very caring state. And when we look at some of these other organizations, we're all in this together and so we work together to help others.

Jeremie Poplin:

Dr. Cunningham, thank you so much for spreading the information about the wonderful things that Blue Cross Blue Shield of Oklahoma, that they've been doing. I can't thank you enough for the time. And you guys were one of the first to kind of step out and kind of lead by example, and I think others followed in your footsteps. So thank you so much for everything that you're doing.

Joseph R. Cunningham, M.D.:

Well, it's my pleasure, Jeremy, and I just hope that everybody stays safe, and remains healthy and we'll do our part.

Jeremie Poplin:

Absolutely. Absolutely. Thank you so much, sir. Enjoy the rest of your day.