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Ebola: Health insurance companies stay calm but alert

Two Americans who contracted the deadly Ebola virus while on a mission in West Africa have returned to the United States, where they are being treated in a special isolation unit of an Atlanta hospital. A half a dozen other patients around the country have had their blood tested because of a concern they might have been exposed to the Ebola virus when abroad.

Ebola is a virus that spreads through contact with blood or bodily fluids. The World Health Organization says Ebola has a death rate of up to 90 percent. The current Ebola outbreak is out of control in West Africa. To date, more than 900 people have died from it.

The missionaries' return to the United States has put some people on edge: Are Americans at risk at home? But health insurance companies, which would have to bear the brunt of the cost of treatment were there to be an outbreak, don’t seem worried.

Health insurance companies stay alert for Ebola outbreaksDr. Ajani P. Nimmagadda, an infectious disease expert and senior medical director for Cigna, says she thinks the possibility of an Ebola outbreak in the U.S. is extremely low.

The possibility of an outbreak here is slim because of the policies and precautions that American medical centers and health care providers always take when it comes to any highly contagious diseases, she says.

Health insurance companies help keep everyone informed

Nonetheless, Nimmagadda says, Cigna, like all health insurance companies, takes any possibility of an outbreak seriously and works with its providers and patients to keep them informed about unusual health threats.

Cigna also continually educates its health care providers and members about what they can do to prevent the spread of infectious diseases, whether it’s the flu, whooping cough or other viruses and infections. For example, she says, "We remind them of the need to wash their hands and to avoid coming in contact with bodily fluids from infected patients," she says. In today's health care settings in the U.S., she says, "you can isolate any contagious [patients] pretty effectively and you take precautions even if you didn't know what it is they might have."

Should an outbreak of infectious disease occur, Cigna would follow the guidance of the Centers for Disease Control (CDC) and local health authorities, Nimmagadda says. It would inform its providers and members about the steps they should take and how they can receive the best possible care if they are affected, Nimmagadda says. "We help our customers get the care they need, regardless of the disease -- whether it's an Ebola outbreak or any situation."

Health insurance companies would be able to spot an outbreak quickly from the insurance claims coming in, says Clare Krusing, director of communications at America’s Health Insurance Plans, a trade group. “The CDC would be the point of contact on how to handle outbreaks of this nature.” 

Spreading the word

Cynthia Michener, a spokesperson for Aetna, says it, too, monitors reports of infectious diseases worldwide. When outbreaks are reported, the health insurer does what it can to ensure its members are able to access necessary care, she says. If, for example, a vaccine or a medicine to treat an outbreak is available, Aetna works with providers to ensure that supplies are sufficient and easily accessible to those who need them.

Aetna also stays abreast of announcements from the CDC and other federal agencies and state and local health departments. Should it become necessary, Aetna would help promote awareness of treatment and preventive care options to its providers and subscribers in the affected communities, Michener says.

Aetna and Cigna would put announcements on their websites and send letters via email or the U.S. mail alerting those who need to take action and telling them exactly what to do, the health insurers say.

Nimmagadda leads a work group at Cigna that includes doctors, customer service reps and provider-relations personnel who look ahead and are charged with supporting unusual situations such as an Ebola outbreak. The team makes sure Cigna's providers would have the resources they need to assist their subscribers in the event of an outbreak or natural disaster. How often the team meets depends on the need. "During the influenza season," Nimmagadda says, "we might meet once a week." Other times, it's less often.

Benjamin Haynes, a spokesperson for the CDC, says health insurance companies can play a role in helping prevent outbreaks by raising awareness among their health care providers and subscribers of the need to take precautions.

"Anything that they can do to help make people aware of what's going on where they live or where they travel is helpful," he says. During the flu season, for example, health insurance companies alert their members to the need to get the flu vaccine. "That's not the same as an Ebola outbreak," he says. "But that's an example of how health insurance companies can play a role in prevention of contagious diseases."

Warning travelers about Ebola also a good idea

Devon Herrick, a senior fellow at the National Center for Policy Analysis in Dallas, a think tank that covers health insurance, says health insurers also need to inform their subscribers who travel back and forth to Ebola hot spots (Sierra Leone, Liberia, Guinea and Nigeria) of their risk of exposure and what they can do to protect themselves.

However, he says, "the risk of Ebola coming to the United States is too small for health insurers to [have to] plan for it."

More from Beth Orenstein here

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