Health Plan Weekly

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     The U.S. Senate on March 25 passed a $2 trillion stimulus package aiming to lessen the economic blow of the COVID-19 pandemic on Americans and businesses — including the health care industry. America’s Health Insurance Plans praised the legislation, which sets aside $100 billion for hospitals, but hinted that more relief is needed for the managed care industry. “Now more than ever, we must ensure that people are able to access the care they need by assuring that their current coverage is — and remains — strong and stable,” AHIP President and CEO Matt Eyles said in a statement. “We are committed to collaborating with policymakers to take action on the solutions necessary to achieve this goal, and we call on Congress to swiftly take additional action to secure and stabilize coverage for families, businesses, and workers.” Read the stimulus bill at

     A clinical research team “has demonstrated that a simple, self-collected test is as effective in identifying COVID-19 infections as the current clinician-collected test,” leading the FDA to update COVID-19 testing guidance, according to a UnitedHealth Group press release. The peer-reviewed study, which was conducted jointly by the University of Washington, Bill & Melinda Gates Foundation, Quest Diagnostics Inc., and UnitedHealth researchers, concludes that the new test “accurately detected COVID-19 in more than 90% of positive patients,” a rate in line with a practitioner-administered test, the release said. Read more at

  • U.S. Health Spending Could Climb to 19.7% of GDP by 2028

    Total U.S. health care spending is projected to increase at an annual average rate of 5.4% over the next decade, reaching $6.2 trillion by 2028, according to CMS. Health expenditures’ share of Gross Domestic Product will rise from 17.8% in 2019 to 19.7% in 2028, as health spending growth will be 1.1 percentage points faster than that of GDP, on average, over the 2019-28 period. According to the forecast, average annual spending growth in Medicare will be the fastest, due to higher projected enrollment growth.
  • CMS Approves Scores of Emergency Medicaid Waivers

    CMS has now approved 29 Medicaid Section 1135 waivers in an effort to give states’ Medicaid programs additional flexibility to augment their COVID-19 response by relaxing certain federal requirements.

    Observers say they anticipate more states approaching CMS with similar requests as the crisis progresses, although the waivers may not streamline care very much for managed care organizations operating within state Medicaid programs.

  • Estimates of COVID-19 Costs Emerge Amid Uncertainty

    In recent days, actuaries and economists have begun to estimate how much it will cost to care for those stricken by COVID-19, the disease caused by the novel coronavirus. Since the crisis is still at an early stage, and medical data collection and analysis is limited, those estimates have a wide range.

    Covered California, the California individual insurance exchange, estimated in a March 22 report that the total cost of COVID-19 coverage for the national commercial market could range from $34 billion to $251 billion in 2020. FAIR Health, a patient advocacy group, in a March 25 report estimated a possible range of $362 billion to $1.449 trillion in charges for hospitalized patients and $139 billion to $558 billion in allowed amounts.

  • From Conference Room to Living Room: Insurers Go Remote

    Like scores of other businesses across the country, a major part of health insurers’ response to the coronavirus outbreak has involved transitioning employees from working in an office to working remotely. However, that task is not always as simple as telling associates to skip their commute, as one health insurance executive tells AIS Health.

    Philadelphia-based Independence Blue Cross started preparing as early as two years ago to allow its employees to work from home as part of its business-continuity strategy, explains Mike Vennera, the insurer’s senior vice president and chief information officer. That effort involved two primary tasks: switching workers from desktop to laptop computers and running small work-from-home pilots with certain departments to troubleshoot any issues that might arise. Vennera notes that Independence was also able to test out its remote-work capacity when large snowstorms hit the Philadelphia region.

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