As coronavirus continues to rapidly spread across the country, the capacity and responsiveness of the United States health care system is being tested. Additionally, the high costs associated with treating Coronavirus Disease 2019 (COVID-19) threaten to strain Americans’ financial resources in an environment where extravagant medical costs cause over 60 percent of all bankruptcies. To project the cost of COVID-19 treatment, researchers analyzed health claims for pneumonia hospitalizations among 18 million enrollees of large employer-sponsored health plans and found that the average cost of a pneumonia hospitalization with major complications or comorbidity cost $20,292. These patients incurred, on average, $1,300 in out-of-pocket costs. However, these costs can be amplified if patients receive care from an out-of-network provider and fall victim to a surprise out-of-network medical bill. On average, out-of-network providers charge 150 percent higher rates than in-network providers and patients face greater exposure to these costs as health plans cover a smaller percentage of costs for out-of-network services. The threat of these costs is heightened as many Americans face uncertainty about their job security during the coronavirus outbreak, as more than half of all American jobs are at moderate or high risk of experiencing layoffs, furloughs, reduced hours, or wage cuts.
In response to the dangers that surprise out-of-network medical bills present to patients’ finances, some hospitals have begun suspending medical bills that are incurred to treat COVID-19, though the entire hospital industry has not yet committed to doing the same. A spokesperson for the American Hospital Association (AHA) emphasized that hospitals are committed to working with health insurers to resolve billing issues that result from a patient receiving out-of-network care. Additionally, the AHA spokesperson encouraged patients to seek appropriate medical care during the coronavirus outbreak without being concerned about the cost of treatment.
Alongside AHA, America’s Health Insurance Plans (AHIP) announced that health insurance providers will work to implement solutions to ensure that out-of-pocket costs are not a barrier to patients obtaining testing and treatment for COVID-19. Specifically, health insurance providers will cover testing for COVID-19 when it is ordered by a physician. Additionally, health insurance providers will ease network, referral, and prior authorization requirements, alongside waiving patient cost-sharing. These measures will help insured patients access COVID-19 treatment with minimal barriers.
Together, the policies implemented by AHA and AHIP will increase patient access to COVID-19 testing and treatment when Americans need it the most. If Americans fully leverage these resources, the country will likely accelerate the containment of the coronavirus outbreak, decrease coronavirus mortality, and ensure that Americans exposed to the virus recover quickly.
Last Updated on May 18, 2020 by Aimed Alliance
