Who should pay COVID-19 testing bill?

Since the early days of the COVID-19 pandemic, we have all heard that testing and contact tracing are key to managing the spread of this virus. Most people assume that testing is free or believe that it should be. Although it may be true that the cost of the test should not be passed on to the public, testing is not free. Early on there were significant shortages of tests and PPE to offer or require testing. These challenges have significantly decreased and testing is available through health systems, urgent care centers, and some employers are offering testing at the workplace.

As we reopen our economy and expand our circles, testing will be at the center of decision-making to inform how COVID-19 is spreading. There are two key questions we need to ask: who should be getting testing and who should pay for the testing. If tests are mandated to fulfill your job, should the government, employer or health plan cover the cost? Like the disease, we are all learning and having to adapt as new information becomes available.

The financial implications of testing far outweigh the cost of caring for a very sick patient, with the total average costs for COVID-19 hospitalizations ranging from $9,000 for lower acuity patients to $20,000 and beyond for higher acuity patients. In fact, the Agency for Healthcare Research and Quality says that the average intensive care unit or ICU cost for a ventilated patient is $2,300 per day, and that cost rises to more than $3,900 per day after the fourth day. From a societal perspective, the first two months spent fighting the pandemic led to an estimated $2.14 trillion loss nationwide, record setting unemployment, and an overall economic downturn. Most importantly, though, is the cost of life. Connecticut has lost nearly 4,000 lives due to COVID-19 and over 120,00 deaths have been reported in the US alone.

In a recent report, the CDC estimates that approximately one-third of coronavirus carriers do not show symptoms. Who should be getting tested now that testing is widely available? Should all essential workers be offered testing at no out-of-pocket costs, should employers of senior living facilities bear the cost of paying for testing of employees who are taking care of loved ones or should health plans and the government share in this burden?

Until a vaccine is available, which appears to be months away at best, should we be expanding our testing to all? As we are seeing in other parts of the country, as we start to reopen, cases may begin to spike. Testing and contract tracing seem to be key to avoiding another surge and potential shutdown.

Widespread testing provides the data we need to manage the spread of the disease and help us to continue to safely open our states in a sustainable manner. As a CEO of a network of urgent care centers, I believe that if the prevailing public health guidance is to test, there should be clear guidelines coming from state advisory boards that outline who should be tested, how frequently and who is responsible for the costs of those tests.

This policy should not be determined solely by elected officials. Instead, we must bring all key health industry professionals to the table together — including payers, hospital systems, urgent care providers and employers — to ensure that all stakeholders’ experiences and concerns are considered in updating the guidelines we all rely on to collectively prevent the spread of COVID-19 as we safely reopen our economy.

Lynne Rosen is the CEO of PhysicianOne Urgent Care, which has 23 locations in Connecticut, Massachusetts and New York.