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This week, America's Health Insurance Plans submitted testimony to the Senate Health, Education, Labor, and Pensions Committee for a hearing focused on improving health equity and outcomes by addressing health disparities during the COVID-19 response. AHIP highlighted health insurers' efforts to address factors such as social determinants of health that can impact the equity of care patients receive.
The group said that since the onset of the pandemic, insurers have built new service delivery models and partnered with providers in various communities to better deliver resources to those experiencing pressing health and social needs.
Insurance providers have committed to overcome social barriers to improve health even beyond the coronavirus pandemic, AHIP said.
"We understand that many social barriers in every-day life play a large role in personal health and health outcomes," the group wrote in its letter. "These factors include limited access to healthy foods, reliable transportation, healthcare services and unsafe or unstable housing. For years, health insurance providers have developed community-specific solutions to address these social barriers -- from investments in local neighborhoods to innovative community improvements and direct assistance for individuals and families."
To exemplify this, AHIP highlighted its own collaboration with the Blue Cross Blue Shield Association and the Biden Administration to launch the Vaccine Community Connectors pilot initiative -- a coordinated effort to vaccinate 2 million seniors aged 65 and older in communities that are most at-risk, vulnerable and underserved, such as Black and Hispanic communities.
The initiative focuses on expanding vaccinations for those who may have difficulty signing up for appointments or getting to vaccine administration sites, such as those who are home-bound, those with disabilities and those who lack transportation options.
The group cited other examples of AHIP members who have made strides in advancing this ethos. Kaiser Permanente, for example, has donated grants totaling $500,000 to date to four nonprofit, community-based organizations in Washington to address systemic racism in the state. The grants will focus on civic engagement and policy, healthcare, education and business and cultural development.
Blue Cross and Blue Shield of North Carolina, meanwhile, invests in sustainable housing in collaboration with Community Home Trust, an organization that supports permanently affordable housing in communities in Orange County, North Carolina. The project will fund needed renovations such as upgrading and cleaning HVAC units and ducts, as well as make improvements to fire safety and lighting.
AHIP also cited Centene, which partnered with Samsung Electronics America to expand access to telehealth for those living in rural and underserved communities. The initiative supplied Centene's providers with Samsung Galaxy smartphones to distribute to patients who wouldn't otherwise be able to access healthcare virtually. The partnership also supplied Samsung Galaxy tablets to providers to conduct telehealth visits with their patients.
WHAT'S THE IMPACT
AHIP floated a number of policy recommendations, including strengthening access to care for underserved populations through Medicare Advantage. The group said there are opportunities for Congress to build on and strengthen Medicare Advantage for the 26.5 million seniors and individuals with disabilities who rely on the program, especially during the COVID-19 crisis. One way is through telehealth.
"In the wake of COVID-19, Medicare Advantage plans took decisive action by expanding telehealth services, including providing coverage for telephonic (audio-only) telehealth," AHIP wrote. "Audio only telehealth helps ensure that patients who have trouble accessing or discomfort using technology or broadband services still have access to necessary care." To that end, AHIP pushed for passage of the Ensuring Parity in Medicare Advantage for Audio-Only Telehealth Act.
It also suggested that efforts could be aided by Medicaid expansion, HCBS funding and extended postpartum coverage.
Throughout the pandemic, the Medicaid program has provided essential healthcare services to millions of Americans who otherwise could not afford health coverage," AHIP wrote. "To ensure that Medicaid remains a stable resource, we urge Congress to take legislative action to support permanent funding for Medicaid expansion incentives, HCBS and extended postpartum coverage. This support is necessary not just for the care delivered today, but the care that will be delivered in the future after the pandemic has subsided."
A number of other witnesses testified at the hearing on Thursday, including Taryn Mackenzie Williams, managing director, Poverty to Prosperity, Center for American Progress, who said those with disabilities have suffered disproportionately during the pandemic. Citing a cross-sectional study, Williams said having an intellectual disability was the strongest independent risk factor, other than age, for mortality due to the coronavirus. She applauded the Affordable Care Act for mitigating insurance losses during the pandemic.
Abigail Echo-Hawk, executive vice president of the Seattle Indian Health Board, said public data infrastructure isn't equipped to collect data on race and ethnicity, and fails to reveal where gaps exist. She noted that Native Americans have been under-enrolled in vaccine trials, adding to a concern over lack of diversity in such trials.
Gene Woods, president and CEO of Atrium Health, also testified, highlighting his organization's creation of a COVID-19 geographic information system map that gathered data on the virus' geographic spread, hot spots, testing density, median income, higher poverty zip codes and minority communities to assist in tackling health disparities.
THE LARGER TREND
Just this week, AHIP praised the introduction of a bill that would improve access to audio-only telehealth for seniors in Medicare Advantage. The bill, which was originally introduced in July 2020, was revived by the U.S. House of Representatives this week.
According to the website of Representative Tony Cárdenas (D-Calif.), one of the bill's cosponsors, the Ensuring Parity in MA and PACE for Audio-Only Telehealth Act would allow providers to offer audio-only telehealth services to MA enrollees. It would ensure that providers are adequately compensated by requiring MA plans to reimburse them for audio-only telehealth visits as if they were in-person visits – unless both parties have agreed to a separate payment policy.