April 13, 2020 Healthcare
As the massive scale of care required to treat the new coronavirus hit hospitals, it was clear that both insured and uninsured patients would need access in order to contain the spread of COVID-19.
But in the U.S., where health insurance through an employer is the primary way to receive care, many patients may abstain from going to the doctor due to costs. This has the potential to further the spread of the virus and has put insurers in the spotlight.
Like many industries, insurers are in crisis management mode, needing to remain nimble to protect their business as well as their partners. It provides a case study of how to tweak services to ensure customers receive the care they need in order to help contain the virus. But it required coordination between the insurers, hospitals and government, and is not without some downsides.
Insurance companies have leaned on their trade group to provide many of the updates, suggestions and demands. America’s Health Insurance Plans (AHIP), the board of which includes several CEOs and chairs from top insurance groups, outlined several initiatives that insurers should undertake.
Some of the steps include covering diagnostic testing and easing network and referral requirements. They also backed utilizing more telehealth tools, which can aid in first-line triage in assessing whether someone should seek a coronavirus test.
“These actions will speed patient care to safe and available settings so that providers can more effectively manage an increasingly complex environment,” according to a March 23 announcement by AHIP.
In the days that followed, UnitedHealth Group took the unusual step of reopening enrollment for corporate clients, so an employee needing coverage could sign on through the end of the first week in April. It was an effort to get coverage for those that didn’t have it. Other insurers, like Aetna, waived cost sharing on coronavirus cases. As hospitals become inundated with cases, the insurers are taking steps to expedite discharges for patients who no longer need a bed, in an effort to free up space faster.
Insurers also used AHIP to convey their asks to the government. The group signed with a number of doctor, hospital and nurse representatives, among others, signaling they need President Donald Trump’s administration and Congress to provide continuous medical supplies, loosen restrictions on types of care and keep the supply chain intact.
The tactic of going through the trade organization, used to provide cover for the entire industry, isn’t a perfect solution. Each company must determine what they can provide based on their membership and financials, which leaves certain insurers taking more drastic actions than others. Whether or not the approach works will depend on how long the pandemic lasts and how much backlash the industry receives, once the world recovers.