US health insurers struggle to cope with the pandemic's challenges

US health insurers struggle to cope with the pandemic's challenges | Insurance Business

US health insurers struggle to cope with the pandemic

While states, municipalities, and even hospitals were quick to respond to COVID-19, private health insurers have been slow to adapt to the challenges posed by the coronavirus – particularly when it comes to supporting telemedicine, it has been suggested.

Telemedicine allows healthcare centers to redirect patients without in-person needs to see a healthcare professional through video. Originally conceived as a way to allow patients to conveniently see a health provider without having to leave their homes, it has now become an invaluable tool for hospitals to redirect patients without in-person needs, enabling them to better focus on serving those afflicted with the coronavirus.

The federal government recently expanded telemedicine provisions under the Medicare plan, which allowed physicians to be paid equally whether for in-person or remote visits. The provisions also approved more devices and programs (like Skype) to be used for telemedicine appointments.

Despite this, health providers are calling out private health insurers for lagging behind.

“I think the issue is that private insurances have not really made it clear that they will reimburse these visits and if so at what cost,” Brooklyn-based orthopedic surgeon Dr. Vipul Patel told The Guardian.

Several other private physicians have revealed to The Guardian that they were struggling to implement telemedicine systems from scratch as coronavirus cases started to climb in their states. Although some physicians said the difficulty lies with their older patients being confused with the technology, others said that the variations in private health insurance plans made it problematic to implement telemedicine protocols without risking revenue – which could affect their employees.

Riddhi Shah, the director of operations of a mental clinic in Michigan, said that it has been tough trying to contact private health insurers these days. The director added that although private health plans have dropped prior authorization restrictions, the clinic still has to deal with new billing codes and financial loss.

Health insurers argued that they are responding to the best of their ability. A Humana spokesperson told The Guardian that the company is not charging patients for COVID-19 testing. Aetna has also waived costs related to the infection for many plan members. Another representative from the Association of Health Insurance Plans (AHIP) noted that various members of the association have pledged their commitment to fighting the coronavirus.

But despite these affirmations, some private health insurers continue to charge patients for other coronavirus-related expenses. AHIP said that out-of-pocket expenses for the treatment will not be waived – those treatments could cost patients thousands of dollars.