The Board of Directors for AHIP, America’s Health Insurance Plans, has released an important statement outlining the actions that health insurance providers are taking to assist care providers and improve patient care during this crisis – particularly for hospitals in the most affected, most at-risk communities.
There is no question that many in-patient hospitals are on the brink of becoming overwhelmed as they care for our most vulnerable patients. Facing dwindling and scarce supplies. Risking higher infection rates for workers. And not having enough doctors to go around. Health insurance providers are committed to working with hospitals to help build capacity.
These are important actions that our industry is taking at a critical time for patients and our nation. They will accelerate patient care, expand provider capacity, and help patients get the care they need in the appropriate setting.
This is the AHIP statement:
We stand together with America’s leaders, our public health heroes, and
Americans across the country in our fight against coronavirus (COVID‐19). We
know that our essential partners – doctors, nurses, hospitals, post‐acute
providers, labs and other health care professionals – are under enormous
pressure and stress. In particular, inpatient hospitals are on the brink of
becoming overwhelmed as they care for our most vulnerable patients, while
simultaneously facing scarcity of supplies, shortages of staff, and higher
risks for infection for their workers.
Given the imperative to expand hospital, health system and provider capacity right now for COVID‐19 patients, the AHIP Board of Directors is committed to partnering with hospitals to build capacity in those regions facing these challenges and to simplify and accelerate the transfer and discharge of patients from hospitals to the safest, clinically appropriate setting of care.
Patients who can be treated safely in alternate sites of care for post‐acute care services should be quickly moved to those facilities. That means inpatient hospitals can transfer patients that are COVID positive or suspected or are treated in regions with capacity challenges without advanced approval to any alternate post‐acute care facilities that are safe, medically appropriate and readily available (e.g., Home Health, Long Term Acute Care Hospitals, Skilled Nursing Facilities, and others) until this crisis is resolved. The discharging and receiving facilities simply need to notify the health insurance provider the following business day. This will allow health insurance providers to remain actively engaged with their member patients and their caregivers on their care journey, help reduce complexity, and ensure care coordination during this chaotic time. It will also enable health insurance providers to be engaged with the receiving facility related to patient care and provider payment. We strongly encourage all health insurance providers to adopt and implement this approach during this current public health emergency.
Additionally, the AHIP Board of Directors is committed to matching
the waivers (e.g., post‐acute) provided by Medicare to facilitate access to
care in the Medicare program where applicable and will temporarily suspend or relax
additional policies as needed in regions where inpatient capacity is most
compromised and most at risk. We strongly encourage all health
insurance providers to adopt and implement this approach during this current
public health emergency.
These actions will speed patient care to safe and available settings so that providers can more effectively manage an increasingly complex environment. They will help expand hospital capacity for COVID‐19 patients so that we can leverage every available care resource. And they will help patients get the care they need when they need it.
Health insurance providers will continue to take action, to help patients get the testing and treatment they need, to help businesses and their workers continue their coverage, and to help policymakers implement effective solutions. Together, we can and will meet this challenge.