This Week in Healthcare Reform: December 11th, 2020

How the coronavirus pandemic accelerated our embrace of digital health; meanwhile, states continue to grapple with the public health crisis; stakeholders point out the false promise of arbitration in addressing surprise medical bills; and, new polling takes a look at public rankings for the new Administration and Congress.

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Week in Review

Digital Embrace: The coronavirus pandemic has resulted in wholesale changes to our health care delivery model.  One particular area in which this is increasingly evident has been how our response to the pandemic has ushered in a wave of digital health technologies.  In the immediate aftermath of the public health crisis, health encounters went virtual.  In fact, some analysts have estimated that COVID-19 sped up the adoption of telehealth by as much as five years.  And, it’s not just the health care space that’s been transformed by the transition to digital.  Organizations, industries, and consumers have all had to adapt to the new, physically-distanced way of doing things that are upending business-as-usual. 

States’ Struggles: With cases spiking across the country, states are struggling to respond to the latest wave of infections heading into the holiday season.  Against that backdrop, there’s increasing concern as state governments grapple with planning ahead of the eventual end to the ‘public health emergency’ declaration, which would result in, amongst other things, less funding to their Medicaid programs.  The current designation is set to expire on 20 January of next year, although it’s assumed that the public health emergency will be extended by the new Administration.  Separately, as vaccines are poised to be approved and distributed, states also find themselves in various stages of preparedness.  The prospect of widespread vaccinations requires a high degree of logistical planning and coordination, from production to administration.  Mounting a successful, far-reaching vaccination campaign, experts advise, depends on achieving a high rate of uptake, which means reaching vulnerable and historically underserved populations.

False Promise of ‘IDR’: As Congress rushes to put a bow on the current legislative session, efforts to tackle surprise medical bills resurfaced this week.  As a reminder, competing proposals aimed at addressing the issue take very different tacks.  One proposal focuses on the median negotiated rate, whereby medical services or goods delivered by out-of-network providers are billed at the median in-network rate in a given geography.  Establishing such a market-based benchmark has widespread support, given that these benchmarks are both predictable and fair.  The alternative proposal focuses on arbitration or independent dispute resolution (IDR).  Mounting evidence has already shown how the use of arbitration has only served to further drive up costs for consumers, prompting stakeholders to warn lawmakers not to be fooled by IDR.  Separately, new polling shows that the vast majority of voters – 90 percent – want Congress to pass legislation that would protect consumers from being subjected to surprise medical bills – with more than three-quarters (79 percent) going so far as to support legislation that would ban all providers from sending surprise medical bills and basing payments to out-of-network providers on rates negotiated between in-network providers and insurers.

Health Polling: While experts have highlighted what they view to be health policy priorities heading into next year, a new poll offers up where the public thinks the incoming Administration and the new Congress should focus their legislative energies going forward.  Unsurprisingly, managing the coronavirus health crisis was at the top of the list, followed closely by protecting coverage for pre-existing conditions and lowering the cost of prescription drugs.  Respondents, however, weren’t overly optimistic about policymakers’ ability to actually accomplish these goals.


A new infographic from the NIHCM Foundation draws attention to important data on loneliness and social isolation, exploring their impacts on overall health, and offering solutions to better address these issues during the ongoing COVID-19 pandemic.

Stay safe and be well.

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