…Nor does it prevent balance billing if a patient is treated by an out-of-network provider or facility. Protection, however, may come with the CARES Act Provider Relief Fund. Providers accepting these funds must agree not to send balance bills to any patient for COVID-related treatment. The effectiveness of this protection will depend on its implementation. Many states already have stepped…
…include: Brokers’ financial incentives to serve individual market customers remains low, despite recent improvements in compensation from some carriers. Compensation for selling short-term and other alternative insurance or insurance-like products is higher than compensation for selling ACA-compliant plans. In many markets, consumers have an improved choice of insurance companies and plans, but many remain frustrated by narrow networks. Lower 2020…
…and improve efficiency of care; innovate in care delivery; and support the economic stability of providers, their communities, and themselves. Insurers say that these efforts will help to provide relief to the communities they serve, ensure that providers have sufficient financial resources to maintain adequate staffing, and reduce the likelihood of members’ care disruption. While insurers hope that these steps…
By JoAnn Volk and Sabrina Corlette Telemedicine has long been understood as a critical tool for reaching patients in underserved communities, including rural areas, and to improve access to services such as primary care and behavioral health. The COVID-19 pandemic has brought renewed and urgent interest in using telehealth to enable remote access to care across service areas and provider…
…lost their jobs. Unfortunately, states that rely on the federal government for outreach are restricted by limited resources, limited data on who is enrolling or attempting to enroll in marketplace plans, and a lack of control over the website consumers visit to find out about coverage options. Consumer Assistance Networks and Call Centers In addition to being able to budget…
…major complications or comorbidities, the average total cost was $20,292. Among inpatient admissions for respiratory conditions requiring ventilator support for 96 hours or more, the median total cost of treatment was $88,114. Out-of-pocket spending for an inpatient admission for pneumonia among large employer plan enrollees averaged $1,300 for stays with major complications or comorbidities and $1,464 for stays without complications….
…cover a comprehensive set of benefits. Although no good data is available about how many people are enrolled in these and other alternative coverage options (such as health care sharing ministry coverage or fixed indemnity products), their documented aggressive marketing tactics make it likely that millions of Americans are enrolled. However, the stimulus bill requiring insurers to cover and waive…
…Given the crisis (and a delay in comprehensive protections even if enacted), Jack Hoadley, Kevin Lucia, and Katie Keith suggest a more immediate solution that Congress could adopt now and maintain until comprehensive protections are enacted and fully implemented. Read the full post on Health Affairs Blog here and find even more resources on how policymakers can address surprise medical…
…data collection means policymakers do not know how many people are enrolled in short-term plans. While some short-term insurers say COVID-19 testing is covered, these plans commonly exclude key benefits like coverage for preexisting conditions and prescription drugs and sometimes place low dollar limits on covered services such as the ICU. Short-term plans are specifically excluded from requirements in the…
The novel coronavirus (COVID-19) has been the cause of confusion and anxiety for individuals and families across the country, especially when it comes to health care. We’ve pulled together some frequently asked questions (FAQs), and added new COVID-19-specific inquiries, from our Navigator Resource Guide to help guide Navigators, brokers, assisters, and consumers through this complex and trying time. We go…
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