Health Plan Weekly

With the COVID-19 pandemic ushering in significant economic uncertainty and consumer frustration mounting over rising health insurance deductibles, benefit designs that aim to give consumers more upfront value appear to be coming back into fashion.

Dave Fortosis, a senior vice president and health care consultant at Aon Hewitt, puts it this way: “There is interest in moving to something more affordable to the average American who is not sitting on a boatload of money.” To that end, companies competing for employers’ business are already rolling out options that seek to address such a need.

Recent events indicate the telehealth boom caused by the COVID-19 pandemic will result in a permanent expansion of virtual care. On Aug. 3, the Trump administration issued an executive order directing HHS to make permanent some of the telehealth regulations it relaxed for Medicare beneficiaries during the public health emergency. Plus, a newly unveiled deal would marry two major telehealth players. However, experts say Congress must act to make expanded telehealth offerings permanent and sustainable, which is unlikely to happen until after the election.

The executive order directs officials to issue proposed regulations that will lock in some of the changes in telehealth policy that the Trump administration included as part of pandemic relief. In response to the order, CMS on Aug. 3 proposed a rule that would permanently allow Medicare to reimburse for certain services that are furnished virtually, “including home visits for the evaluation and management of a patient (in the case where the law allows telehealth services in the patient’s home), and certain types of visits for patients with cognitive impairments.”

✦ Recognizing that many people — especially seniors — haven’t been comfortable leaving home for routine health care services, Humana Inc. said on July 23 that it’s planning to mail more than 1 million in-home preventive care screening tests to members. The initiative, which will run from June to September and triple the number of in-home screening tests Humana sends to members, will focus “particularly on members in need of colorectal cancer screening and diabetic condition management,” the insurer said. Medicare Advantage members will receive the tests for free, while eligible Medicaid members will receive the diabetic management test kits only. Read more at https://huma.na/2DhhzsU.

✦ Reversing previous trends of flat or negative enrollment growth, the number of people covered by Medicaid and the Children’s Health Insurance Program (CHIP) rose by 1.2 million between December 2019 and April 2020. That’s according to a new analysis of CMS data conducted by the Kaiser Family Foundation, which also found that Medicaid and CHIP enrollment increased by 800,000 people between March and April of this year, coinciding with rising income and job loss tied to the COVID-19 pandemic. Adults accounted for the vast majority of the enrollment increase. Visit https://bit.ly/3hL7bZb to learn more.

While Anthem, Inc. has seen less of an enrollment dip in its commercial business than it originally feared when the COVID-19 pandemic and economic recession first took hold, the insurer’s executives said during a July 29 earnings conference call that they expect that attrition to accelerate in the coming months as some furloughs become permanent job losses.

From March 31 to June 30, Anthem saw enrollment in its commercial and specialty business line drop by 290,000. “But as you think about unemployment, that was fairly muted,” especially when it comes to Anthem’s risk-based business, President and CEO Gail Boudreaux said during the question-and-answer portion of the earnings call. She and other Anthem executives attributed that effect to the fact that many companies have thus far furloughed rather than laid off workers, thanks in part to federal stimulus funding.