As Covid-19 Cases Rise, Insurers Reduce Coverage for Virtual Visits

By: Anna Wilde Mathews and Robbie Whelan from the Wall Street Journal

Major insurers are taking different approaches to covering remote care, which is typically done by phone or video. The companies are offering an array of deadlines, reimbursement strategies and charges, depending on factors like the type of plan or the purpose of the medical visit. Doctors and hospital officials say the complex rules are leading to confusion.

The cost-sharing charges create concern that patients, when faced with an increased financial burden for Telehealth, might delay or avoid visits. “It is really very complicated,” said Ted Okon, executive director of the Community Oncology Alliance.

“It should be simplified and unified so that you don’t have to constantly go back to this grid.” For example, the new Anthem and United Health changes only apply to certain plans and don’t include the generally free virtual visits related to Covid-19. Some other insurers ended cost-sharing waivers for Telehealth visits earlier in the year. “Shifting the co-payments back to patients presents the risk that patients will cancel Telehealth appointments or seek in-person visits that heightened the threat of infections,” said Thomas Owens, Senior Vice-President of Duke University Health System.

Telemedicine grew rapidly this spring and summer as the Coronavirus pandemic shut down swaths of the U.S. health-care system. Doctors and hospitals around the country canceled much of their routine, in-person care and patients stayed home because they were nervous about the risk of infection.

Insurers and the federal Medicare program rushed out expanded coverage for virtual visits, often including reimbursement for doctors on-par with what they previously received for seeing patients in their offices. Doctors and hospitals say they are also struggling with uncertainty about future coverage of Telehealth, since many insurers have said their current policies are guaranteed only until the end of the year. Christi Siedlecki, chief executive of Grants Pass Clinic, which provides primary care in Grants Pass, Ore., said she is worried that the clinic will lose Telehealth payments when the federal public health emergency tied to the pandemic lapses. “It’s not certain what the future holds,” she said. “Everything right now is based on the state of emergency.” 

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August 2020