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Analysis

Capital BlueCross Offers Advance Payments to Pennsylvania Providers Affected by COVID-19

By Jack O'Brien  
   May 29, 2020

The insurer, based in Harrisburg, Pennsylvania, stated that advance payments will be made to eligible providers based on average monthly payments from last year.

Capital BlueCross announced plans Thursday to issue advance payments to independent healthcare providers affected by the ongoing coronavirus disease 2019 (COVID-19) outbreak.

Eligible providers for the BlueCross program must have experienced at least a 40% decline in "average payments for services provided to Capital BlueCross members," during March and April.

The insurer, based in Harrisburg, Pennsylvania, stated that advance payments will be made to eligible providers based on average monthly payments from last year.

The advanced payment program is the latest initiative by BlueCross to assist providers, including the extension of preauthorizations, waived member costs for diagnostic testing for the coronavirus, and an expansion of providers whose telehealth services are covered. 

Related: Blue Cross Blue Shield Insurers Sue CVS, Alleging Drug Pricing Fraud

"One of our primary goals as a health insurer is to make sure our members and the communities we serve have access to care, and independent providers are critical to that goal," Todd A. Shamash, CEO of Capital BlueCross, said in a statement. "By providing advance payments to help them through this difficult time, we are helping to ensure these providers will be there for our members long after the pandemic has passed."

The announcement came days after the Hospital and Healthsystem Association of Pennsylvania (HAP) estimated that hospitals across the state have lost $10.2 billion due to the pandemic.

Related: Pennsylvania Hospital Association Projects $10B Deficit for State's Hospitals

Hospitals have a significant economic impact on the Keystone State, accounting for more than one in every 10 jobs in Pennsylvania, according to a HAP study released in December.

Providers in the state made a total economic impact of $136.1 billion in Fiscal Year 2018, according to the same report.

Related: Pennsylvania Hospitals Made $136.1B Impact in FY 2018

To remedy the financial pressures related to the coronavirus outbreak this spring, Pennsylvania state government established the Hospital Emergency Loan Program (HELP) and dispensed $324 million in short-term relief funding to affected providers. Geisinger Health received $100 million in HELP funding.

Related: Hospitals Across Pa. Get $324M via Loan Program; Geisinger Gets $100M

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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