Key Healthcare Trends for 2020 and Beyond was published earlier this year. The following is some thoughts on the impact that Covid-19 will have on employers and other industry stakeholders.
Payers are relaxing or putting various utilization management actions (like PA, refill limits) on moratorium during the crisis. Either as an attempt to avoid worse market changes and to show compassion during the pandemic or just getting ahead of anticipated rule changes, these efforts are the right thing to do in both commercial and Medicare insurance programs. Allowing unfettered coverage when following CDC Guidance and access to testing is another example of such changes.
Provider organizations or health-systems have accepted patients regardless of coverage or ability to pay, and plan to sort out the economics after the crisis period. Many organizations have restricted unnecessary procedures or non-emergent care, instead utilizing Telehealth measures to better handle the load of routine care and screening to keep people out of the emergency room. Payers have expanded Telehealth coverage and encouraged its use to scale healthcare capacity to deal with the surge of this viral pandemic across the country.
The CARES Act will provide some economic balancing to include medical related debt, but it is still too early to tell how effective or long that initial Congressional effort will provide relief to businesses along with individuals. We are now in unchartered waters that most likely continue into the summer.
The claims landscape remains a huge question that will likely not be answered at least till the summer 2020. To what extent operational strategies will change going forward or financial ramifications to plan for, the complexities require more time to sort everything out in an effort to determine our new normal.
Short-term, hospitals and governmental agencies are facing decisions that will only worsen around life-saving care, available supplies, care innovation on the fly, and how to prepare for the growing wave of patients being seen in high density urban areas.
Employers are also struggling with preparing or not to re-start their business while managing the short-term chaos of cash-flow that trickles down to employees seeking to earn wages. While not thinking too detailed about health care costs down the road, most employers are worried when or if they continue, will health care be available and affordable into 2021. Current plan designs and financial structures are not equipped to address this type of crisis from public health. What commercial or governmental insurance may look like by 2025 is now even more hypothetical this early in the timeline of our pandemic crisis.
For sure, change is now happening and all aspects of the managed healthcare marketplace has been effected. Specifics on what the new marketplace will look like in 2021-22 is too early to even speculate. Regardless, planning for new patient care systems, health care delivery, and insurance coverage designs is certain to accelerate in the coming weeks – not months.
Takeaway: Covid-19 layers the harsh lesson of an uncertain, “unexpectable” health catastrophe on an already shaky economic commitment by employers to covering costs of employees’ health treatment. The magnitude of the uncertainty about the commitment, even over a period as brief as a year, could hardly have been made more dramatically. Normally, the shock of awareness of this kind of economic fragility begets policymaking expediency.