Former Vice President Joe Biden begins his transition to power as the new coronavirus breaks dismal records in the United States and hospitals in some areas are ready to strike again. Strengthening the federal response to the pandemic is the main industry problem for the new president.
On the current path, Biden is ready to take the lead if the deadly pandemic could reach unprecedented levels in terms of the number of cases, hospitalizations, and deaths.
Many hospitals and health systems across the country are warning that the virus threatens to overwhelm their doctors and resources and call for action as administrators and officials urge the general public to wear masks and socially distance themselves to contain the spread.
While the January 20 pandemic will undoubtedly be a top priority for a Biden administration, there are other major issues that need to be addressed in the early days.
Healthcare Dive spoke with several influential hospital leaders to discuss key issues the president-elect is expected to address during his first 100 days in office.
1) Pandemic response, continued relief
Coronavirus cases in the United States are on the rise again, with the total number of cases surpassing 10 million on Monday, following a largely over-the-counter response from the Trump administration. After a brief hiatus with the virus, after government lockdowns addressed new cases earlier this year, providers are again faced with the dire potential of a growing workload pushing them beyond their resources.
As a result, many are asking for quick help from the new Biden administration.
“A key concern now is making sure our hospitals receive the support they need to respond to the new wave of COVID-19 infections,” said Beth Feldpush, senior vice president for policy and development. Defense of Major America Hospitals, a professional security association. – network hospitals.
Hospitals want more federal funding, especially as many could be forced to curb lucrative election cases to conserve resources and staff in the growing cases of COVID-19. Hospitals are hopeful that this funding issue can be addressed during the Lame Duck session in the final months of President Donald Trump’s term, although many see it as a major hurdle.
2) Bolstering healthcare coverage
The pandemic has caused a historic number of job losses as the economy has shut down completely to contain the spread of the virus. For most insured Americans, health insurance is tied to employment, so losing a job can mean losing health insurance at a time of great potential need.
However, many employers continued to provide health benefits during worker layoffs and recognized the seriousness of the situation.
However, hospital executives say they can use the profits made under the Affordable Care Act, as long as it is not struck down by the US Supreme Court, to improve overall coverage.
“All of those things that make reporting smoother and easier take precedence,” Kahn said.
The American Hospital Association also advocates for better access to coverage. Insurance coverage is vital for hospitals that would otherwise have to deal with the uninsured without reimbursement.
Kahn said some key areas of concern are the improvement of subsidies for those who buy insurance with Healthcare.gov and the COBRA coverage subsidy. Insurance is extended to employees in the event of job loss, which can be costly.
3) Increased access to Medicaid
Biden’s health officials are expected to reverse the Trump administration’s actions that undermined the Medicaid program, hospitals say. Medicaid has faced a spate of guidelines over the past four years that experts say have restricted access to safety net coverage or compromised the integrity of the program, which includes approximately 75.5 million people. And it has seen enrollments in the coronavirus recession skyrocket.
In particular, the CMS has provided states with unprecedented flexibility to deviate from programming and eligibility standards, sometimes in exchange for limited funds, and has encouraged states to adopt programs that limit Medicaid’s eligibility to work or volunteer hours.
The Trump administration has also proposed a rule setting new reporting requirements for additional payments to Medicaid providers and restricting their payment options. This Medicaid financial liability rule was popular with the administration but was withdrawn by CMS in September due to vendor responses.
4) Reimbursement challenges
The new administration is expected to reverse Trump-era policies that cut funding for facilities that care for a large percentage of low-income or vulnerable patients, Feldpush said. This includes reductions in outpatient visits and Part B drug payments to hospitals under the 340B drug pricing program.
Biden’s CMS director can reverse the 23 percent cut of $ 340 billion, but Biden himself didn’t mention it as a priority, according to consulting firm PwC.
Hospitals also want to continue the march towards more value-based care interventions and stop receiving volume payments, which was crucial, especially in the early days of the pandemic when volumes were falling.
“The Biden administration is expected to continue the federal government’s move toward value-based care, a paradigm shift that began with George W. Bush,” noted PwC.
Executives also want laws to restore the 2% cuts in Medicare withdrawals, another issue they will hopefully address on this matter.
Providers have turned to virtual assistance en masse this year as the pandemic stifled personal use of non-emergency services and the Trump administration temporarily removed barriers to service. Hospitals were no different, and some facilities saw usage increase several thousand percentage points in the middle of the year, providing them with a valuable way to make up for lost revenue.
Hospitals not only connect patients with providers for use cases like post-operative care but also see the benefit of virtual care by connecting remote specialists for services like telecommunications or telemetry.
“We think this is a turning point,” lawyer Aurora Rogers said of telemedicine. The system will push for the telemedicine exemptions issued in the context of the public health crisis to be permanent. “This is one of the priority issues that we will pursue,” said Rogers.
In particular, Rogers would like the number of providers authorized to provide telemedicine services to be expanded beyond the scope of the national emergency.
Virtual assistance is generally bipartite in support, although most of the changes vendors seek would require Congress intervention.