Treatment for Covid-19 and Insurers

As the pandemic begins to effect more Americans, Vice President Mike Pence met with insurers to address concerns about the cost of treatment for those who are insured. Members of this group agreed to waive co-payments and deductibles for Covid-19 testing, however America’s Health Insurance Plans (AHIP) reiterated that out-of-pocket costs for treatment would not be waived.

Costs for those who develop pneumonia can top $20,000 according to the IBM MarketScan Commercial Claims and Encounters database, which includes the amount paid by insurance plans and costs paid by the patient. This does not include any balance or “surprise’ billing. Read more about how the pandemic is effecting insurers, the healthcare system and the public.

Source: Kaiser Family Foundation

Coronavirus Law Will Help Families and Businesses

The first part of the new “Families First” bill makes testing for coronavirus free to the public, without deductibles or copayments. It also includes a temporary “6.2% increase in federal payments to Medicaid for states.”

Paid sick leave for companies with fewer than 500 employees will be provided if employees can’t work because they’re quarantined or are experiencing symptoms of Covid-19 or If they are caring for someone in isolation or have children in schools that are now closed.

The federal government is also providing states with nearly $1 billion in grants to cover processing unemployment benefits and unemployment insurance. States with high unemployment, will receive assistance to provide additional help for those who have already used up their benefits.

The Society of Professional Benefits Administrators further clarified this aspect of the benefit package, “It also changed language to clarify that the mandated benefit given to employees cannot exceed the tax credit employers receive, that the tax credits fully reimburse employers for healthcare premiums for employees on leave due to the illness, and that employees at qualifying companies will not get 10 additional days of paid sick leave — they will be ensured 10 total.”

Finally, nutritional assistance will help more people qualify for SNAP benefits, and about half of the half billion-dollar allocation will help those on WIC. Some households who have children who have a closed school for at least five consecutive days will also get assistance

Read more about the Families First aid package.

Source: NPR, Society of Professional Benefits Administrators

Patient Records Will Be Easier to Access and Track

The Department of Health and Human Services (HHS) recently announced two new federal rules that will allow consumers to have access to all their health care records, including claims information through an API, and will prevent information blocking, which is considered by the Trump administration to be “anti-competitive”—not giving consumers enough transparency about the cost of their medical care.

The new rules won’t take effect until 2022, but will include CMS which has already adopted practices around sharing health data and claims data with patients and in 2021, electronic alerts about patients who are admitted, discharged or transferred will be required to be sent to health care providers to improve care coordination.

Read more about the new rules.

Source: Healthcare Innovation

AI in Health Care—Use with Caution

We’ve read and summarized many articles about the potential benefits that artificial intelligence (AI) has in health care but recently reviewed an article from Wired magazine, about the potential hazards of AI. In short, AI is only as good as the data it receives. The issue is that AI may interpret non-relevant data as important and incorporate it into an algorithm and create recommendations that exacerbate the issues of over-testing, over-diagnosis, and over-treatment. If we ask the wrong questions, AI will contribute to wrong answers or diagnosis. Read more about this counterpoint.

Source: Wired.com

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