With fewer claims to pay out, some health insurers are using their improved balance sheets to help struggling providers secure loans, pay claims earlier and, in some cases, underwrite patients’ outstanding bills.
Many doctors, clinics and hospitals have suffered financially during the coronavirus pandemic because lucrative elective surgeries have been delayed and demand for nonemergency care has declined. The scenario has been particularly difficult for health-care providers that spent more to ramp up capabilities to treat Covid-19 but haven’t seen a surge in patients.
About 30 U.S. states have stopped or restricted elective surgeries since March 15, according to Moody’s Investors Service. The American Hospital Association has asked insurers to help provide financial support through advanced or accelerated payments.
The number of claims filed in March declined 20% at Blue Shield of California, according to finance chief Sandra Clarke. The Oakland, Calif.-based insurer has set aside $200 million to act as a guarantor on loans for hospitals, doctor’s offices and clinics and to purchase expected insurance claims in advance, she said.
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The company also is helping certain fee-based providers switch to fixed monthly payments to ensure a steadier stream of income, and it is underwriting some patients’ financial obligations to improve cash flow, Ms. Clarke said.
CareFirst BlueCross BlueShield, a nonprofit health-care insurer that operates in the Baltimore metro area, is spending $110 million to provide interest-free financial support to hospitals and independent providers, said finance chief Jenny Smith. The funds will have to be repaid at a later time, according to CareFirst.
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“CareFirst has a solid cash-plus position. We are leveraging this piece,” Ms. Smith said. “In my mind, it is a small exposure to our balance sheet.”
CareFirst is allowing Giorgio Kulp, a pediatrician in North Bethesda, Md., to bill for appointments conducted via video or telephone. The insurer also has expedited certain reimbursements to help with his cash flow.
Yet it hasn’t been enough. To cut costs, he has reduced office hours. Partners in affiliated offices have furloughed more than two dozen employees.
UnitedHealth Group Inc.,
the parent company of the nation’s biggest health insurer, has accelerated about $2 billion of payments to help alleviate pressure on doctors and hospitals. It also is offering as much as $125 million in small-business loans to health-care providers in which it holds a stake, according to an April 15 earnings statement.
Insurers have good reason to ensure providers survive the pandemic: “There is a risk that there is a smaller provider network after this,” said Brad Ellis, a senior director at Fitch Ratings. “So health insurers are trying to maintain the network.”
As restrictions are lifted, health-care providers expect an upswing in revenue, but such a quick recovery is expected to be patchy. In the absence of a surge in demand or help from insurers, providers can attempt to claim a share of about $175 billion in federal aid set aside for them. But some have found it difficult to access those funds.
“We have been trying to figure out how to apply for the various grants. It was difficult to navigate,” said Dr. Kulp, who added he is still awaiting approval on applications for federal assistance.
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