To flatten the curve, healthcare leaders are developing data analytics and AI-powered solutions, setting the stage for the future of technologies. The $2T Stimulus package covers a broad range of healthcare services during COVID-19. About $16 billion to provision the country’s stockpile of medical equipment, including ventilators, Personal Protective Equipment or PPE. Over 3,000 hospitals offering healthcare services to uninsured patients can avail an $8 billion insurance through the stimulus package, which will reflect in their Medicaid payments in 2020 and 2021.
The Federation of American hospitals estimates that healthcare systems will receive about $3 billion more due to the suspension of a considerable cut in Medicare fees (2%). This cash infusion will exponentially benefit doctors, nursing homes and home health companies among others. The allocated funds include $117 billion for hospitals and veterans’ health care and $16 billion for a stockpile of pharmaceutical and medical supplies. With significant measures taken worldwide, here’s how to reduce the impact in the short and long term:
- Measures to mitigate potential financial losses. Primary measures could include a cap to financial losses incurred during COVID-19 or to completely waive off money that providers owe the insurance in correspondence to the value-based contracts. Reducing administrative burdens of providers would also add tremendous value, like – quick and prompt approval of prior authorization cases and claims, timeline extensions for claim submissions.
- Bridging the gaps in care – disparate IT systems and clinician burnout are some of the major issues cropping up amidst the outbreak, and healthcare stakeholders need to rethink strategies to create a long-term solution. Healthcare plans, Center for Medicare and Medicaid Services (CMS) and other private payers need to focus their efforts on value-based contracting.
- Leverage data analytics and Insights for customized care. CMS and private payers have announced upfront reimbursements through Accelerated and advance payment program. While financial support may offer a sigh of relief, especially for Physicians and small practices, a one-size-fits-all approach may blur the lines in identifying the ideal provider that needs utmost support. Data-driven approach and profiling such as – patient mix, risk exposure, IT capabilities enable payers to offer customized support, while transforming payer-provider experience and trust.
In essence, assist providers with risk management, a key value add for provider organizations — helping them manage risks and unexpected losses during COVID-19. Consider re-insurance and risk management solutions to providers, specifically individual physicians and small practices. While developing value-based care models, harness the stop-loss clause to enhance provider experiences and loyalty.
Below stats shows the increasing scope of Healthcare and pharma after COVID-19
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