The ongoing battle against the Covid-19 pandemic that the world faces continues. While progress is being made, different variants lead to a return to normal and continue to be checked. In the United States, at least 70% of adults are now vaccinated against the virus, and Covid-19 is paving the way for real health care reform. The necessary reforms were established in consideration of three elements:
- Current exemptions and flexibility for public health emergencies. Which will last?
- The rise of healthcare integration in the post-Covid world
- Long-term changes in reimbursement
Current exemptions and flexibility for public health emergencies. Which will last?
The current public health emergency for Covid-19 has been extended to October 17, 2021, and may be extended to the rest of the year. Therefore, the Minister of Health and Human Services has the power to allow certain exemptions and flexibility under the Social Security Act (known as the 1135 exemption). Although state laws still apply, many states have also incorporated these into their own rules.
Some key exemptions and their meanings include:
- Expansion of telemedicine services. Medicare will pay for telemedicine visits, including ED and your residence, at a cost similar to in-person visits. FQHC (Federal Qualified Health Center) and RHC (Rural Health Clinic) can benefit from specially designed reimbursements.
- The hospital’s Skilled Immediate Care Facility (SNF) coverage. Previously, Medicare Part A did not cover SNF unless you had been in an acute care hospital for 3 days before.
- Expansion of Emergency Access Hospital (CAH). In the past, CAH’s initial bed limit was 25, check-in time did not exceed 96 hours, and there were restrictions on allowing them to enter “non-rural” areas. This has relaxed.
- It is easier to get family health. This allows more clinicians to speed up access to home healthcare opportunities. In addition, family health agencies do not have to see new patients face to face before accepting them.
- Expansion opportunities for professional national licenses. Provides providers with the flexibility to practice in different states without going through cumbersome state licensing procedures, similar to the high-speed interstate medical license contract (IMLC). In the long run, this is essential to ensure the availability of doctors in an increasingly urgent supply shortage.
- Faster medical insurance registration. Allows to reduce the administrative burden and begin to solve the problem of palliative care doctors, which makes it easier for them to become part B fee-charging clinicians.
- Various paperwork deadlines, especially for SNF and home health agencies. Eliminate the work of submitting evaluation documents and reorder durable medical equipment (DME) more easily, without having to meet face-to-face or request a doctor’s order.
These are very important healthcare reform frameworks. But will these last?
Based on the rich experience in this field, parts 1, 4, 5 and 6 will definitely have the greatest chance to stay. However, technically supported care will always exist. As the former CMS administrator Seema Verma said about telemedicine, “This wizard is no longer in the bottle… There is absolutely no turning back.”
The rise of healthcare integration in the post-Covid world
Welcome to the prosperous town. Why now?
A recent Bain & Company study showed:
- 50% of hospital managers said that their organization is very likely to make one or more acquisitions within the next two years.
- Nearly 70% of independent physician practices are suitable for mergers or acquisitions.
- Doctors like to be acquired by organizations that provide both financial stability and doctor autonomy.
What does this mean for the future? in short:
- Larger systems acquire and integrate smaller hospitals to expand their “hub and spoke” model to minimize revenue loss outside the system and maintain better patient care continuity, especially when the need to move from small hospitals to In the case of a large hospital.
- The practice of doctors who do not want to bear the burden of Covid-19 to withstand another storm will hope to fulfill it, but can still gain flexibility in their own practice of doctors.
- The reality of allowing small primary care practitioners to compete heavily in the market may be over… OK? Less competition may mean higher medical costs.
Changes in reimbursement
This pandemic will also serve as a catalyst to accelerate the transition from pay-for-service reimbursement to value-based reimbursement (most likely through a per capita model) and “sever” the link between volume and payment. By the end of last summer, more than 6 million Americans were uninsured because they were unemployed. We should expect to see the expansion of ACA to some extent and further advance the concept of single payer.
The last challenge facing medicine-and the one that the country has always faced-is to finally get rid of symptomatic treatment and focus on health and root causes. This certainly has a lot of social and political overtones, but you will see the continued movement of value-based reimbursement.
Affected by the epidemic, important links in medical reform are being advanced and significant progress has been made. As the pandemic continues, we can expect more changes to take place.
Photo: Madmaxer, Getty Images
