Medical insurers innovate to aid shaken health care industry

When the coronavirus two months ago limited medical practices’ ability to perform elective procedures, major health insurers across Arizona had to move quickly to find innovative ways to help providers stay in business and keep patients receiving care.

There is an overwhelming need right now. The American Medical Association reports that 97 percent of physician practices have experienced a negative financial impact directly or indirectly related to COVID-19. Less than half of primary care clinicians have enough patient volume and cash to stay open another month. 

Meanwhile, surveys of primary care doctors indicate that many providers have had problems securing forgivable loans through the new federal Paycheck Protection Program (PPP). 

With insurance claims down, major health insurers in Arizona including Arizona Complete Health, Blue Cross Blue Shield, Cigna, and UnitedHealthcare are pouring resources and funding into helping providers and patients. 

Most are incorporating more flexibility for providers, helping them start or expand telemedicine, and providing resources and assistance to help them access PPP loans and financial assistance. They have eliminated and reduced many copayments, given credits on premiums, eliminated many COVID-19 related charges, and made substantial donations to help medically vulnerable populations. 

“This has been a surreal pandemic from so many factors so we need to make sure we are investing in our health care sector and ensuring that we have viable providers coming out of this process,” explained Monica Coury, vice president of legislative and government affairs for Arizona Complete Health (ACH), a subsidiary of the Centene Corporation that serves Arizonans through Medicare Advantage, Marketplace, AHCCCS and other programs. 

Innovation required 

Coury said health plan administrators have had to “think outside of the box” to help providers — and patients — survive. 

For example, when Centene learned that some members with complex care needs did not have enough data or minutes on their cell phones to receive telehealth visits, it issued funds to providers to purchase phones or upgrade patients’ phones to avoid healthcare crises. 

Here’s a look at a few of the measures Complete Health and other Arizona insurers are taking to shore up providers and patients during the coronavirus. 

UnitedHealth Group accelerates $2 billion for provider liquidity

UnitedHealth Group announced it is accelerating nearly $2 billion to health care providers to support liquidity needs, initially investing more than $70 million to help communities in need and protect the health care workforce.

This month it also announced it is providing premium credits and discounts worth $1.5 billion to health plan members and employers impacted by the pandemic. For commercial fully insured individual and employer customers, credits ranging from 5 to 20 percent will be applied to premium billings in June.

For a complete list of resources, go to: UHC COVID-19 provider resources. 

Cigna emphasizes flexibility 

Cigna Healthcare of Arizona is helping providers a number of ways, including making it easier for hospitals to transfer patients to long-term acute care hospitals, skilled nursing facilities, and acute rehabilitation facilities to help manage COVID-19 patients.

Like all insurers, helping providers move to telehealth has been a big emphasis. Telehealth now accounts for approximately 85 percent of Cigna Medical Group visits. Of these, 25 percent are virtual video visits, company officials said.

They are offering billing and reimbursement guidance for providers and free home delivery of up to 90-day supplies for prescription maintenance medications and 24/7 access to pharmacists.

The Cigna Foundation, in partnership with the New York Life Foundation, has launched The Brave of Heart Fund and is contributing an initial $50 million to the fund that provides grants and support to the survivors of frontline healthcare workers who lose their lives fighting COVID-19.

“Our customers, our employees, and our communities need us now more than ever,” said Courtney Nogas, Cigna spokesperson. “Our top priority is the safety and service of our customers, patients, clients, employees and partners. And, Cigna will continue to do our part to support those on the frontlines.”

For a complete list of resources, go to: Cigna COVID-19 provider resources.

Blue Cross Blue Shield launches prepayment assistance

One of the ways Blue Cross Blue Shield of Arizona (BCBSAZ) is supporting primary care providers during the pandemic is through a new prepayment financial assistance program for providers in the BCBSAZ Patient Centered Medical Home (PCMH).

These advances will help BCBSAZ PCMH providers cover monetary shortfalls due to the global health emergency and provide critical funding, so they can continue serving Arizonans in need of medical attention, the company stated. Providers can receive partial prepayment of their estimated annual quality incentive payment. 

For more information about how BCBSAZ is supporting healthcare providers, members and the community during the COVID-19 pandemic, visit:  azblue.com/coronavirus.

Arizona Complete Health offers PPP loan and telehealth assistance

As health providers move to more virtual patient visits, Arizona Complete Health is providing $5 million to help its federally qualified health centers “stand up”  telehealth programs and support in incorporating them into their business models, Coury said.

The company also is providing webinars and other resources to help providers access PPP loans, grants and other financial assistance.

“Our physician practices and healthcare providers are mostly small businesses just like everybody else and, so, there are multiple funding streams right now to help shore up the healthcare sector,” she said. 

As the economy reopens, they will be faced with a new healthcare model, she said. 

“This will be something that sticks with us,” Coury said. “What does it look like after we transition out of this situation?  We cannot load up waiting rooms anymore. That’s going to be in the past. We’re going to have to manage through that and we’re going to have to do that together; payers, providers and policy makers.” For a complete list of Arizona Complete Health resources for providers, visit: Complete Health COVID-19 provider resources.