Major health systems and payers are
eliminating patient financial responsibility for coronavirus treatments,
ideally making care more accessible.
By Sara Heath
April 01,
2020 - High medical costs and patient financial responsibility are
significant sources of stress for healthcare consumers, and that has never been
more true than during the coronavirus outbreak.
As the virus first
started spreading across the country, questions about how patients would pay
for medical care and whether COVID-19 treatment could lead to surprise medical
bills or financial ruin ran rampant.
Notably, experts
questioned whether the promise of high healthcare costs and out-of-pocket
spending would deter some patients from seeking medical care, regardless of
feeling coronavirus symptoms.
Even in the best of
times, large medical bills are prohibitive for patients. Data from a 2019
Integrated Benefits Institute (IBI) survey found that
high medical costs limit care access for a third of low-income workers. A
Gallup poll conducted at the end of 2018 found similar trends, reporting that
29 percent of patients delay care access because of concerns about patient
financial responsibility.
And with coronavirus
treatment carrying a price
tag of nearly $1,300 in out-of-pocket costs for individuals
with employer-sponsored coverage, experts predicted similar patterns. Patients
might not access care to avoid getting that bill, healthcare leaders posited.
That isn’t a good
situation even in the best of times, never mind during the spread of the novel
coronavirus which is notoriously extremely contagious.
To stem that issue,
the healthcare industry is addressing patient financial responsibility. Both
major healthcare systems and leading health payers have made announcements that
could mean good news for patient finances.
By eliminating
patient billing practices through the duration of the coronavirus spread and
limiting or canceling patient cost-sharing, the healthcare industry is working
to mitigate patient financial responsibility during the time of coronavirus.
HEALTH
SYSTEMS CANCEL PATIENT BILLING
As a part of their
efforts to treat patients and enable access to care, major health systems
across the country are hitting the pause button on their patient billing
practices as they relate to coronavirus care.
“The last thing our
patients should worry about if they experience symptoms characteristic of this
coronavirus is the cost of seeking care,” Lloyd H. Dean, CEO of CommonSpirit
Health, one of the health systems suspending
patient billing for COVID-19 care.
This decision was
made with the knowledge that high out-of-pocket healthcare costs can dissuade
many patients from seeking treatment, something that could be worse for health
systems down the line.
“While we cannot yet
know how COVID-19 will spread in the days and weeks ahead, our care sites will
remain available to our communities. The most important thing now is for people
who experience symptoms of the coronavirus to contact their health care
provider and seek medical care if directed to do so,” he continued.
CommonSpirit is not
the only health system to adopt this practice. In March, Providence St. Joseph
Health and Advocate Aurora also announced plans to suspend patient billing for
coronavirus treatment.
“This gives us the
necessary time to align with insurers, testing and lab partners, and our state
and federal governments involved in providing various elements of COVID-19
health care,” a spokesperson from Providence St. Joseph Health told Axios on
March 12.
However, this is not
necessarily the norm, according to the American Hospital Association. In
a statement also
to Axios, AHA implored federal government to help healthcare organizations help
cover the cost of coronavirus care because hospitals simply cannot afford to
waive all of these fees.
“Any individual who
believes they need screening or treatment for COVID-19 should seek appropriate
medical care, and concerns about cost should not prevent patients from seeking
care. Hospitals commit to working with insurers for any patient who receives
out-of-network care. We ask the federal government to assist hospitals in
covering the costs of care for the uninsured, consistent with programs
implemented after other previous emergencies or natural disasters.”
This conundrum comes
as healthcare organizations scramble to get their hands on personal protective
equipment (PPE) and make ends meet while they hit pause on
non-emergency or elective treatments.
HEALTH
PAYERS ELIMINATE CORONAVIRUS TREATMENT COST-SHARING
Major health payers
across the country are going the same route as health systems and eliminating
patient out-of-pocket costs for coronavirus treatment and testing.
Aetna, a part of CVS
Health, will be waiving cost-sharing for members receiving coronavirus
treatment at in-network healthcare facilities, the payer announced on
March 25. As of right now, Aetna says this offer will last through June 1.
This comes alongside
efforts from Blue Cross Blue Shield of Massachusetts and CareFirst.
Aetna’s move is a
part of its efforts to drive adequate patient access to care amid the COVID-19
outbreak, acknowledging that insurer cost-sharing can be prohibitive for many
patients.
“The additional steps
we’re announcing today are consistent with our commitment to delivering timely
and seamless access to care as we navigate the spread of COVID-19,” said Karen
S. Lynch, President, Aetna Business Unit and Executive Vice President, CVS
Health. “We are doing everything we can to make sure our members have simple
and affordable access to the treatment they need as we face the pandemic
together.”
Cigna and Humana
made similar
announcements at the end of March, as well.
“Our customers with
COVID-19 should focus on fighting this virus and preventing its spread,”
said David M. Cordani, president and chief executive officer at Cigna.
“While our customers focus on regaining their health, we have their backs. Our
teams of experts are working around the clock to support front line health care
workers, increase flexibility for hospitals, and deliver greater peace of mind
to those we serve.”
Humana used similar
logic, noting that patients should be able to access coronavirus
care regardless of ability to pay.
“We know we’re
uniquely positioned to help our members during this unprecedented health
crisis,” said Bruce Broussard, President and CEO of Humana. “It’s why
we’re taking this significant action to help ease the burden on seniors and
others who are struggling right now. No American should be concerned about the
cost of care when being treated for coronavirus.”
CHALLENGES
REMAIN FOR LOW-INCOME PATIENTS
Despite health system
and payer efforts to put a lid on high healthcare costs, at least as they
relate to coronavirus treatment, the disease outbreak has still spurred on a
number of issues for low-income patients.
Income and
socioeconomic status are key social determinants of health being exacerbated by
the coronavirus spread. Low-income patients may struggle to purchase a
stockpile of groceries as people flock to supermarkets during social
distancing.
Individuals with
lower socioeconomic status may also experience less flexibility working from
home, either seeing their jobs furloughed, being laid off, or still going into
work in essential businesses, potentially putting themselves at risk for the
disease.
The coronavirus
outbreak has shone a light on gaps in the social safety net, pushing some
philanthropic organizations to step in.
Health systems, consulting firms, and other groups with immense capital have
been offering grants to help support low-income patients during this trying
time.
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