Federal actions alone can't fill a growing revenue gap resulting from reduced private payments for suspended elective care, Richard Pollack, president and CEO of the American Hospital Association, said in an April 1 letter to insurers. He said commercial insurers should make efforts similar to the federal government's to support cash flow amid the COVID-19 pandemic.
The letter, addressed to the CEOs and executive leadership of CVS Health, Aetna, Anthem, UnitedHealthcare, Cigna, America's Health Insurance Plans and the Blue Cross Blue Shield Association, said private payers can "make a significant difference in whether a hospital or health system keeps their doors open during this critical time." While the federal government has made temporary changes that boost and accelerate Medicare reimbursement to help hospitals with coronavirus-related financial hardship, Mr. Pollack said the efforts aren't enough and private insurers should do the same.
Mr. Pollack asked insurers to specifically allow providers to opt in to periodic interim payments and/or accelerated payments as long as the COVID-19 crisis persists. His organization is also asking private health plans to reduce prior authorization processes and payment edits while covering cost-sharing for COVID-19 treatment. Additionally, AHA wants payers to expedite processing of outstanding claims to reduce billions in accounts receivable.
A growing list of insurers that includes Aetna, Anthem and Cigna has already committed to covering cost-sharing related to COVID-19 treatment. Several insurers have expanded their telehealth coverage and waived costs for the treatment as well, while others have already implemented new prior authorization policies in an effort to reduce administrative burden. In addition, UnitedHealth Group committed an initial $50 million to fight the COVID-19 pandemic, with $30 million being earmarked for healthcare workers.
In an email to Becker's, AHIP's Senior Vice President of Communications Kristine Grow provided the following statement: "We have called for more emergency resources and support for providers on the front line of fighting the virus. We have expanded the use of telemedicine so that doctors can keep seeing their patients. And during the course of this national emergency, many health insurance providers are reimbursing for telehealth care at the same rate as in-person care, to encourage people to stay safe at home. We have eliminated prior authorization requirements during this pandemic to ensure swift treatment of those who have COVID-19, and to ensure swift movement to alternative sites of care for patients who don't. We are ensuring health insurance providers are considered an essential service so that we can keep paying providers swiftly."
Editor's note: This article was updated April 2 at 9:23 a.m. CT.
More articles on payers:
Aetna to waive cost-sharing for COVID-19 hospitalizations
UnitedHealth to launch COVID-19 test
BCBS of North Carolina to cover hydroxychloroquine, chloroquine to treat COVID-19