As the COVID-19 pandemic rolls on, providers are asking payers for one thing: cash.
But as health plans have taken steps to ease the burdens on hospitals and physicians, they’ve been hesitant to agree to offer accelerated or interim payments or other cash infusions.
The American Hospital Association sent a letter last week to major national payers urging them to offer these payments, as Medicare has taken up a similar initiative. America’s Health Insurance Plans (AHIP), the largest lobbying group for payers, responded by touting that health plans are waiving cost-sharing for telehealth and treatments and that they’re committed to easing administrative burdens and claims processing.
The insurance group didn’t mention waiving prior authorization—a major roadblock for providers—or moving toward accelerated or interim payments.
None of the big-name health plans have announced such cash infusions as they unveil new programs aimed at supporting providers through the COVID-19 pandemic.
Aetna, for example, said Monday that it has changed prior authorization requirements nationwide for its contracted post-acute care hospitals and long-term acute care hospitals to make it easier for them to transfer patients and clear space in emergency departments.
In addition, Aetna pledged to ensure that providers continue to receive payments without disruption even as the insurer offers greater flexibilities to plan sponsors, including options to waive the costs associated with COVID-19 treatment.
Aetna said there would be no financial hit to the provider because of the waivers—it will cover the amount of cost-sharing that would have ordinarily fallen to the patient, avoiding a loss for providers.
Aetna announced Friday that it would extend the waivers to out-of-network hospitals and to individual market and Medicare Advantage members through June 1.
“We’re committed to helping providers, plan sponsors and our members navigate through this unprecedented time,” said Karen Lynch, president of Aetna and executive vice president of CVS Health, in a statement.
Humana unveiled a slate of similar proposals last week. AHIP also said in late March that its board of directors, which includes the biggest health plans aside from UnitedHealthcare, would work to help providers on capacity.
There are signs that providers’ requests are being heard on the regional level, though. For example, Blue Shield of California, which has 4 million members, said Monday that it would work to provide up to $200 million in direct financial support to providers including financial guarantees, advance payments and contract restructures.
The insurer is working with two financial institutions to assist providers with guaranteed loans and payment advances on expected costs. The goal, Blue Shield said, is to ensure providers can make it through the next sixth months with favorable repayment terms.
Blue Shield said it would send out further information to its providers soon as details are confirmed.
“We are arranging millions of dollars of support to clinicians and hospitals that are heroically serving Californians on the frontlines of this fight,” said Paul Markovich, CEO of Blue Shield, in a statement. “We are providing financial solutions, reducing administrative barriers and offering new digital tools to help them face this unprecedented challenge.”