by Bloomberg 30
Mar 2020 by John Tozzi
Two of America’s largest health insurers, Cigna
Corp. and Humana Inc., said they will waive out-of-pocket costs for patients
who need treatment for COVID-19.
Leaders of both companies called it the right thing
to do to help alleviate financial stress for their members and to remove
barriers that could keep people from getting needed medical care.
“We’re stepping in as aggressively as we can to
support care access and peace of mind,” Cigna Chief Executive Officer David
Cordani said in a joint interview with Humana CEO Bruce Broussard.
The immediacy of the coronavirus crisis has
overshadowed America’s longstanding conflicts over the price of medical care
and how costs should be distributed. But those problems are simmering in the
background as the pandemic meets a population where access to health care was
already precarious for tens of millions of people.
About 45% of working-age Americans don’t have
adequate health coverage, according to a survey by the Commonwealth
Fund, a health research non-profit. That includes those who have no insurance
and those with high out-of-pocket costs relative to their income. Last week, an
uninsured 17-year-old in Lancaster, California, died of suspected
COVID-19 after being turned away from an urgent care centre and sent to a
hospital instead, according to a video the city’s mayor posted on
YouTube.
Health insurers moved earlier this month to lift
cost-sharing for COVID-19 diagnostic testing, a practice that was
later mandated by Congress for the duration of the public health
emergency. Insurers and government health regulators have taken other steps to
encourage telemedicine, lift prior-authorisation requirements and allow
hospitals to quickly discharge patients to post-acute settings.
Surprise Billing
Cordani and Broussard said they don’t want disputes over payment or concern about doctors being out-of-network to dissuade anyone from seeking care. Cigna said it would pay providers its in-network rates or Medicare rates, and both executives said patients would be shielded from balance or surprise billing by doctors or hospitals.
Cordani and Broussard said they don’t want disputes over payment or concern about doctors being out-of-network to dissuade anyone from seeking care. Cigna said it would pay providers its in-network rates or Medicare rates, and both executives said patients would be shielded from balance or surprise billing by doctors or hospitals.
“We’re going to keep it between the provider and
the company,” Broussard said.
Both Cigna and Humana said it was too early to
tell whether expenses like deductibles, co-payments, and co-insurance --
portions of the medical bills that patients are responsible for -- were keeping
their members from getting treatment for COVID-19.
“In general, what we see is that when there are
significant financial barriers people do delay care,” Broussard said.
Half of all adults with employer-based health
insurance said they or a family member have delayed or skipped care in the past
year because of cost, according to a 2019 survey from the Kaiser
Family Foundation and the LA Times.
The decision to waive cost-sharing for COVID-19
treatment will apply across all of the two companies’ fully insured products,
executives said. Self-insured employer plans -- where the employer holds the
financial risk and the insurer administers benefits -- will be encouraged to
follow but can opt out of the practice.
Medical Services
The companies are emphasising that they are not merely insurers pooling financial risk but actively delivering needed medical services to their members. Company nurses and other clinicians are reaching out to patients, particularly those most vulnerable to the virus and the economic hardship of shutting down much of the economy. Broussard said Humana helped direct more than 10,000 meals to senior citizen members in need last week.
The companies are emphasising that they are not merely insurers pooling financial risk but actively delivering needed medical services to their members. Company nurses and other clinicians are reaching out to patients, particularly those most vulnerable to the virus and the economic hardship of shutting down much of the economy. Broussard said Humana helped direct more than 10,000 meals to senior citizen members in need last week.
Cigna insured about 17 million members in
medical plans, mostly for employers, at the end of last year, and another 76
million in pharmacy coverage. Humana, whose business is focused on private
Medicare Advantage plans, covered about 17 million across medical and drug
plans.
Cigna said the policy will take effect
immediately and last through May 31. Humana said the policy has no current end
date, and the company will re-evaluate as the situation changes.
Both executives said it was too early to say how
the pandemic might affect health insurance premiums for next year. Both
declined to say in detail how it might impact their broader businesses.
Copyright Bloomberg News
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