Health industry groups urge more action, low-cost testing for coronavirus

Several healthcare industry groups are taking steps to inform their provider members to tackle the spread and risks of the new coronavirus, COVID-19.

A letter from the board of directors of America’s Health Insurance Plans (AHIP) specifically noted it wanted to help with costs associated with testing for and treatment of COVID-19, which could be a barrier to people who need care. AHIP’s membership boasts some of the biggest insurers, including Aetna, Centene and many more.

COVID-19, which originated in China, has spread to more than 100,000 globally, including 99 cases in the U.S. and 10 total confirmed deaths. The disease, which is characterized by cough, fever and breathing trouble, has been called “an emerging, rapidly evolving situation” by the CDC.

The letter’s direction on reducing costs for patients comes after one Florida patient who, after returning home after traveling to China, exhibited flu-like symptoms and sought treatment. While he was ultimately negative for COVID-19 when tested at a hospital, he was left with a medical bill topping $3,000, The Miami Herald reported. Such high costs are likely to deter other patients from seeking testing or treatment for the disease.

AHIP’s letter touched on “three critical areas” health insurers are already working on, including prevention, testing and treatment. Its first critical step to address the growing risk of coronavirus is addressing out-of-pocket costs by working with the public and private sectors.

“We will cover needed diagnostic testing when ordered by a physician. We will take action to ease network, referral and prior authorization requirements and/or waive patient cost sharing,” the letter reads.

The group also will take action to ensure supplies of regular prescription medicines are not at risk and develop ways to increase flexibility for preventive services, benefit design and treatment options so people can get care immediately.

As an industry group, AHIP’s other top priorities include working with healthcare providers to ensure infected people can get care. AHIP committed to sharing information and coordinating care through its networks to “identify, diagnose and treat infections.” Part of this effort includes telehealth, which is being touted as a diagnostic tool that could help identify high-risk patients without infecting others in public healthcare facilities. Expanding policy flexibility around telehealth will be critical for the success of the tool.

Another big industry group, AMGA, called on CMS to waive telehealth restrictions to better enable healthcare providers to treat patients suspected of having COVID-19. Telehealth can prevent unnecessary exposure of the disease to healthcare professionals while also providing treatment to patients. AMGA represents multispecialty groups and integrated care systems, with more than 175,000 physicians across its member organizations.

“AMGA members will be on the frontline of treating patients who contract this novel coronavirus, but not every patient should come to the doctor’s office,” AMGA President and CEO Jerry Penso, MD, MBA, said in a statement. “Instead, we can use telehealth to determine the best course of action for patients. Providers will be able to triage patients and keep some patients home, which will help minimize further spread of the disease.”

AHIP’s third step included educating people on how to prevent the spread of the disease by working with the CDC, localities and other agencies.

AHIP is not the only healthcare industry group responding to the crisis. The American College of Emergency Physicians (ACEP) developed an emergency guidance to better inform healthcare professionals and providers, public health officials and government officials to manage the outbreak. The plan, “The National Strategic Plan for Emergency Department Management of Outbreaks of COVID-19,” contains a five-pillar response for specific to emergency departments to handle the biological threat. The plan includes a facilities checklist and a personal preparation checklist for individual emergency physicians.

As anticipation grows for more community transmission of COVID-19, we have to ensure our health care system is coordinated and has the capabilities necessary to respond rapidly and effectively,” William Jaquis, MD, FACEP, president of ACEP, said in a statement.

The spread of the COVID-19 is crippling the events industry, with a string of healthcare conference cancellations over the last week. Most recently, the Healthcare Information and Management Systems Society (HIMSS) canceled its 2020 conference, originally scheduled to take place over March 9-13 in Orlando, Florida. The event typically draws more than 40,000 health IT professionals and has never been canceled before in its 58-year history.