AHIP Releases COVID-19 Priorities as States Consider Re-Opening

America’s Health Insurance Plans (AHIP) teamed with chief medical officers from member health plans to develop a list of principles related to coronavirus care that plans should prioritize as states begin reopening.

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“These principles leverage the vast clinical and population health experience and data that health insurance providers have, and they are intended to complement the heroic efforts of clinicians fighting on the front lines of this crisis,” the statement read.

“They also reflect important clinical priorities as states begin to plan for re-opening businesses across the country, including elective and preventive health care services. Health insurance providers, led by their CMOs, will continue to evaluate and evolve these principles as clinical and scientific evidence grows, and as federal and state leaders further define their roadmaps to reopening.”

First, the health plans committed to maintain and increase access to coronavirus testing and treatment through a variety of channels. The plans will continue to work toward opening more special sites of care to handle coronavirus-related health concerns for those who are high risk and seniors, including drive-through testing sites.

With so many new sites of care opening up, it will be critical for providers to use proper diagnostic and billing codes to track patient care, the statement stressed.

Second, telehealth, including virtual care and telemedicine, will remain a primary method of diagnosing the disease and a channel for treatment, the health plans stated. Telehealth protects both the patient and the provider from contracting the disease through lack of in-person interaction.

AHIP noted that telehealth is especially convenient and effective for practices and procedures related to:

• Primary care
• Behavioral healthcare
• Specialty diagnosis and care
• Chronic disease management
• Physical, occupational, and speech therapy
• Rural areas
• Coronavirus epicenters, like New York City

Physical care is not the only matter at hand, plans recognized. So the health plans emphasized that access to care for mental healthcare needs would be high on their priority list. Telehealth factors strongly in their strategy for accomplishing this.

According to the Mental Health Association, the number of screenings for mental health conditions has been increasing since the coronavirus epidemic started. The severity of results has also increased, with severe psychosis results rising seven percent past the average of the past five months. Americans under 25 are especially susceptible to mental health decline, as 90 percent of those who are screened receive moderate to severe depression results.

Additionally, payers committed to member engagement, both by setting up sites of evidence-backed information distribution and also by reaching out to at-risk members. Health plans have been using and will continue to use nurse hotlines and websites and intend to expand their existing coronavirus-related call centers.

As important as it is to share new information on COVID-19 with patients, it is equally important to communicate appropriate information to providers.

Thus, the health plans will also prioritize supporting providers by sharing coronavirus-related practices and discoveries.

By educating providers on preventive measures and treatment routines that have proven effective for coronavirus patients, plans can help clinicians better reduce the spread and severity of coronavirus.

The statement suggested sharing coronavirus containment strategies, lab availability, and lab testing options. Health plans can also share treatment protocols related to methods for diagnosis and care as well as managing patients. With personal protective equipment (PPE) resources running low, payers can help spread ideas about better strategies for PPE.

Along those lines, payers will also continue efforts to increase access to PPE and update providers on ways to protect themselves from coronavirus.

The health plans recognized the need to extend certain flexibilities for providers to lower their administrative burden. Flexibilities related to prior authorizations, medication refills, and hospital transfers have been essential to enabling timely coronavirus care.

Finally, payers committed to enabling the flow of coronavirus data between payers, providers, government, and other stakeholders.

With these policies in place, payers—along with the rest of the country—are bracing for America’s impending reopening and what that could possibly entail.