Health Insurance Carriers along with Healthcare Partners Are Addressing COVID-19 ChallengesMay 26, 2020
The unprecedented challenges posed by the COVID-19 pandemic is throwing challenges to New Hampshire, as well as to the entire nation. People are wondering how health insurance carriers will be responding to this challenging time.
The state’s insurance companies are working with their health delivery partners like hospitals, health systems, and individual providers to address the different challenges associated with the pandemic. The insurers and health delivery partners are taking significant measures to prevent and slow the spread of the disease, ensuring access to coverage for testing, diagnosis, and treatment for COVID -19.
Emergency and Immediate Actions of Health Insurance Providers during this Crisis:
Health insurance carriers have waived off prior authorization requirements for people seeking COVID-19 testing or treatment. Insurers have eliminated patient cost-sharing for COVID-19 testing and treatment, and now they don’t have to pay any co-pays, co-insurance, and deductibles. This further help hospital with guaranteed payments, and has also removed a barrier to healthcare.
Cost-sharing for telehealth services is waived off along with expanding access. Due to this burden of the health system has been eased, and hospitals can care for people who are in dire need of medical care. This limits the healthcare workers and patient’s exposure to the disease.
Insurers are protecting patients from surprise medical bills, by covering their testing and treatment without requiring them to share any amount. Insurance carriers are encouraging healthcare providers everywhere to do not send surprise medical bills to patients during this national crisis.
Health insurance carriers have urgently simplified or changed medical management processes like simplifying and speeding up the transfer and discharge of patients from hospitals to the post-acute facility or home.
The trade group America’s Health Insurance Plans on March 19 and April 8 joined with the Blue Cross Blue Shield Association, and have requested Congress to help families and businesses get their healthcare coverage. They also recommended providing more funds to ensure that Americans who lost jobs during the COVID-19 pandemic can maintain their coverage, and establish a temporary risk-reducing program to ensure that health premiums do not increase and healthcare benefits remain the same.
Demonstrating their collaboration, health insurance providers led a coalition with doctors, hospitals, health care professionals, and pharmaceutical manufacturers to plan for coordinated public and private sector response to COVID-19. Health insurers are working on emergency measures like expedited payments, eliminating nonessential audits, and payment to out-of-network providers, resulting in workforce expansion
President Trump signed an emergency relief legislation that was supported by AHIP and its members that allows direct federal funding for hospitals and health care providers. The emergency funding included $100 billion in direct federal assistance, a 20% rise in Medicare inpatient care payments for COVID-19 related claims, and a 2% rise in Medicare payments for all providers.
The emergency order of Governor Sununu created a $50 million Healthcare System Relief Fund for hospitals and healthcare providers. If these efforts of federal and state are not found enough, then the health insurance companies of New Hampshire would assist further government enhancement.
The adverse financial consequences of the COVID-19 are also felt by the health insurance providers. Experts estimate in one of the studies that testing and treatment cost of COVID-19 in the first year itself will reach $250 billion in a worst-case scenario. It is a huge amount and is more than the entire capital and surplus of the entire health insurance industry in 2018 and it does not even expect the costs to be borne by Medicaid managed care and Medicare Advantage. A different study estimated that the testing and treatment costs of COVID-19 to commercial healthcare providers along with Medicaid managed care plans and Medicare Advantage might range from $56 billion to $555 billion over the coming two years. Health insurance carriers should have the necessary funds to cover the unexpected costs of COVID-19.
During the pandemic time, businesses and their workers are at high risk due to economic slowdown, which is also affecting their health insurance coverage affordability. The combined effect of increasing unexpected costs along with reducing dollars due to the pressure on businesses, individuals, and families are imposing financial strain on health insurance carriers.
Even the health insurance carriers of New Hampshire are committed to helping the state’s healthcare system and helping them meet the COVID-19 challenges through emergency measures. They are also working with state stakeholders and policymakers to make health insurance more affordable for the families, employers, and employees of New Hampshire.