CommonSpirit Health, Others Suspend Patient Billing for COVID-19

March 20, 2020 - One of the nation’s largest health systems recently announced that it will suspend patient billing for the testing and treatment of COVID-19.

Patients presenting at one of CommonSpirit Health’s 142 hospitals and more than 700 care sites across 21 states for COVID-19 care will not receive a bill, the health system confirmed in the March 17 announcement.

“The last thing our patients should worry about if they experience symptoms characteristic of this coronavirus is the cost of seeking care,” Lloyd H. Dean, CEO of CommonSpirit Health, stated in the announcement.

“While we cannot yet know how COVID-19 will spread in the days and weeks ahead, our care sites will remain available to our communities. The most important thing now is for people who experience symptoms of the coronavirus to contact their health care provider and seek medical care if directed to do so,” he continued.

With the announcement, CommonSpirt Health added its name to a growing list of hospitals and health systems stopping patient billing while providers manage the COVID-19 pandemic.

Last week, Advocate Aurora Health based in Milwaukee and Downers Grove, Illinois and Providence St. Joseph Health, a 51-hospital system headquartered in Washington both announced that their facilities will not send patient bills related to COVID-19 treatment.

“This gives us the necessary time to align with insurers, testing and lab partners, and our state and federal governments involved in providing various elements of COVID-19 health care,” a spokesperson from Providence St. Joseph Health told Axios on March 12.

There are over 14,200 confirmed cases of the novel coronavirus in the US, according to numbers compiled by Johns Hopkins University at the time of publication. Public health officials expect that number to climb, with one infectious disease expert reportedly estimating 96 million cases overall.

While providers are scrambling to free up capacity to treat the expected influx of COVID-19 cases, they are also struggling with the price tag of the outbreak.

Some patients have already come forward with their own stories about how much coronavirus-related testing and treatment is setting them back. One Miami resident who recently visited China for work was charged $3,270 for treatment related to COVID-19. A teacher in New York also shared her $10,382 bill after visiting a local emergency department for COVID-19 symptoms.

The insurance companies in these cases covered a majority of the expenses. But the individual in Miami still had to pay $1,400 in out-of-pocket expenses for his test, while the teacher was stuck with a $75 bill for visiting the emergency department.

In general, patient financial responsibility for medical care is on the rise given the popularity of high-deductible health plans and the introduction of new short-term health plans. The latest analysis on out-of-pocket spending from TransUnion Healthcare found that patient financial responsibility increased 12 percent on average from 2017 to 2018, leaving patients on the hook for over $4,600 for inpatient care, $1,100 for outpatient care, and $600 for emergency department visits.

Commercial payers have overwhelmingly agreed to waive co-payments and deductibles for COVID-19 testing. However, America’s Health Insurance Plans (AHIP) clarified in a statement to Politico that treatment could still come at a cost for patients testing positive for the virus. And those costs may be significant.

COVID-19 patients could rack up $20,000 in treatment charges and ultimately be responsible for over $1,300 of those charges, a recent analysis from Kaiser Family Foundation found. The analysis examined the potential cost to employer health plans and their enrollees of COVID-19 treatment by analyzing typical spending for hospital admissions for pneumonia.

Hospitals and health systems are recognizing that patients could face significant – and likely unexpected – bills by suspending patient billing related to COVID-19 testing and treatment. The suspension also gives the health systems time to work with their payer partners to determine how to bill for treating the novel coronavirus.

“CommonSpirit will continue to work with payers and federal, state, and local officials to determine the cost-sharing associated with providing care related to COVID-19,” the health system stated in its announcement.

But the policies adopted by CommonSpirit, Advocate Aurora, and Providence are not the norm. The American Hospital Association told Axios:

"Any individual who believes they need screening or treatment for COVID-19 should seek appropriate medical care, and concerns about cost should not prevent patients from seeking care. Hospitals commit to working with insurers for any patient who receives out-of-network care. We ask the federal government to assist hospitals in covering the costs of care for the uninsured, consistent with programs implemented after other previous emergencies or natural disasters."

Either way, hospitals and other providers are likely to see cash flow slow during the outbreak, especially with more organizations refusing upfront collections in light of new social distancing recommendations.