Minnesota Blues CEO Craig Samitt on COVID-19, 2021 Rates Increases, Telehealth, Medicare for all, and WFH | Managed Healthcare Executive
On COVID-19 cases
We represent about 40% of all of the insurance in Minnesota. And so while we don’t necessarily tally our membership against the Minnesota experience, you know, you can estimate that, that of the 2,500 or so cases that we’ve experienced that, in all likelihood, you know, in the ballpark of a 30% to 40% range would represent the impact that that our membership has had. I think the impact for us has been, frankly, what it’s been for everyone. It’s this is a scary and a surreal and unprecedented time.
On BCBSMN expenditures this year
Right now, our current projections are that it [lack of expenditures for elective procedures and other routine care] won’t be an offset, that actually we would experience or at least we’re projecting to experience a financial loss.
We think that we’re going to see some significant financial fluctuations over the course of the rest of the year, and then, frankly, that that’s the role that an insurance company plays that, that we are there to support the peaks and the valleys of, of healthcare coverage and care delivery that that comes in goes through the course of a community’s lifetime. So in the near term, you’re right, we’re seeing a deferral of elective procedures, we estimate that we’ve seen it at least a 50% reduction in services. And so in the immediate near term, we’re certainly seeing a decline in services and obviously a decline in cost.
The next wave, we expect is going to be a significant surge in expense. Minnesota is not quite at its peak. And we don’t envision that we may be at our peak for up to another 15 to 30 days. So we’re expecting, as we’ve seen in other states, a significant rise in costs associated with [COVID-19] testing with treatment.
I think the third phase is also going to be likely a savings phase that immediately after the peak. I think we would expect to go back to a period where folks may be concerned about going back to the hospital or going back to physicians, even for elective procedures, just because we’re fearful about recurrence, so I think we’re going to see a low utilization.
And then the last phase will essentially be recovery, which is all of the pent-up demand, as we feel more comfortable.
So when we look at it longitudinally, there’s going to be there’s going to be valleys and there’s going to be peaks, and at least our projection right now, it’s going to be negative not positive in terms of utilization cost.
On 2021 rate hikes
I think it’s likely too soon to tell. I know that many organizations are beginning to analyze pricing for next year, but there are so many variables and there’s so many moving parts.
I don’t know if we would expect, if we envision, that there’s going to be a new surge of cases. Perhaps so. But if there isn’t a recurrence of the pandemic next year, then the question is, is would we expect utilization to be on par with what it was before the pandemic or potentially even less?
We’ve been calling it the day after tomorrow, the day after tomorrow we envision that they’re going to be many more services provided in the home or in the community or online. I think there’s still going to be some hesitancy about going to go to the emergency room or to the hospital or . going go to the doctor with minor complaints. And so we could estimate that we may potentially see a lower utilization in 2021.
The final thing that I would say [if there an economic depression], I don’t think employers will be able to, and individuals will not be able to, afford significant premium increases. And so I think we will all want to do what we can to suppress inflationary returns on pricing, because we just won’t be able to sustain it and afford it as individuals or as a society going into the next year.
I’ve mostly spent my career in in organizations that have wanted to fix healthcare and really transform the way we deliver care. And so I’ve been a fan of telehealth for decades now and I’ve been waiting for telehealth to have its day and that day is finally here. One of the very first things that we did was to open up telehealth immediately to our members through a through a partner [Doctor on Demand] who provides national telehealth. And we wanted to eliminate all barriers both technologically as well as financially.
So whether it was COVID-related symptoms or non-COVID-related symptoms, folks should stay at home. So we opened up that immediately. However, we also wanted to make sure that we helped our provider partners develop technology to see their own patients.
We’ve wanted to make sure that we can offer some resources and support for providers to connect but we also realized that you know, we should be paying for telehealth services, at least in the near term comparably as we pay face-to-face services if, if it’s the same type of visit that a patient would have with their doctor face-to-face, and it’s approximately the same amount of time for the physician, why would reimbursements not be more comparable?
So I think we’re going to reevaluate everything, including payment policy. Obviously, there have been historical restrictions that have predominantly been CMS-based, but I think we all have had them and that we have to review these policies and change them so that we can offer a much more convenient and, in some cases, equally high quality service to patients through virtual means.
We wouldn’t have thought that it would be this type of shock to the system to really launch us into a reinvented future. But I think that reinvented future is now here, and I don’t think there’s going to be a going back. I think that this is here to stay.
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