DaVita ends efforts to inform Medicaid-eligible patients about ACA plans

DaVita Kidney Care halted application support for Medicaid-eligible patients for ACA plans and premium assistance following a St. Louis Post-Dispatch report questioning the Denver-based company’s motivations.

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Internal emails obtained by St. Louis Post-Dispatch from open enrollment 2016 show DaVita told Medicaid-eligible patients their monthly premiums for private insurance would be covered by the American Kidney Fund, a nonprofit to which DaVita contributes. DaVita’s outreach included helping patients complete applications for private health plans — which typically reimburse higher than Medicaid — and American Kidney Fund’s assistant program. DaVita also sent brochures to targeted patients explaining the “additional” coverage’s increased transplant, physician and out-of-state treatment access. 

DaVita defended its actions as required insurance option education and said members with additional ACA coverage had more access to specialty physicians and comprehensive drug coverage. 

Approximately 2,000 patients will be affected by DaVita’s halted efforts, according to a company release.  

In August CMS said it is considering rules to stop healthcare providers who are seeking higher reimbursements from steering patients toward ACA individual health plans over Medicare or Medicaid. DaVita said it will take a $140 million hit to its operating income should CMS implement the policy changes.   

More articles about payer issues:
5 quick facts about tiered marketplace health plans
Top White House economist calls ACA death spiral ‘absolutely impossible’
Maine insurance co-op hikes out-of-network deductibles over 400%

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