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1.
Milbank Q ; 99(2): 542-564, 2021 06.
Article in English | MEDLINE | ID: covidwho-1280253

ABSTRACT

Policy Points We compared the structure of health care systems and the financial effects of the COVID-19 pandemic on health care providers in the United States, England, Germany, and Israel: systems incorporating both public and private insurers and providers. The negative financial effects on health care providers have been more severe in the United States than elsewhere, owing to the prevalence of activity-based payment systems, limited direct governmental control over available provider capacity, and the structure of governmental financial relief. In a pandemic, activity-based payment reverses the conventional financial positions of payers and providers and may prevent providers from prioritizing public health because of the desire to avoid revenue loss caused by declines in patient visits.


Subject(s)
COVID-19/economics , Delivery of Health Care/economics , COVID-19/epidemiology , COVID-19/therapy , Delivery of Health Care/organization & administration , England/epidemiology , Germany/epidemiology , Humans , Insurance, Health/organization & administration , Israel/epidemiology , Pandemics/economics , Reimbursement Mechanisms/organization & administration , SARS-CoV-2 , United States/epidemiology
2.
Am J Manag Care ; 27(4): e101-e104, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1194879

ABSTRACT

In public health insurance programs, federal and state regulators use network adequacy standards to ensure that health plans provide enrollees with adequate access to care. These standards are based on provider availability, anticipated enrollment, and patterns of care delivery. We anticipate that the coronavirus disease 2019 pandemic will have 3 main effects on provider networks and their regulation: enrollment changes, changes to the provider landscape, and changes to care delivery. Regulators will need to ensure that plans adjust their network size should there be increased enrollment or increased utilization caused by forgone care. Regulators will also require updated monitoring data and plan network data that reflect postpandemic provider availability. Telehealth will have a larger role in care delivery than in the prepandemic period, and regulators will need to adapt network standards to accommodate in-person and virtual care delivery.


Subject(s)
COVID-19 , Health Planning , Health Services Accessibility/standards , Insurance Coverage/standards , Insurance, Health/standards , Public Sector , Health Insurance Exchanges , Humans , Insurance Coverage/legislation & jurisprudence , Insurance Coverage/organization & administration , Insurance, Health/legislation & jurisprudence , Insurance, Health/organization & administration , Medicaid/legislation & jurisprudence , Medicare/legislation & jurisprudence , United States
4.
Psychiatr Serv ; 72(1): 100-103, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1059742

ABSTRACT

Because of the COVID-19 pandemic, many mental health care services have been shifted from face-to-face to virtual interactions. Several health policy changes have influenced telehealth uptake during this time, including changes in technology, Internet connectivity, prescriptions, and reimbursement for services. These changes have been implemented for the duration of the pandemic, and it is unclear if all, some, or none of these new or amended policies will be retained after the pandemic has ended. Accordingly, in the wake of changing policies, mental health care providers will need to make decisions about the future of their telehealth programs. This article briefly reviews telehealth policy changes due to the COVID-19 pandemic and highlights what providers should consider for future delivery and implementation of their telehealth programs.


Subject(s)
COVID-19 , Drug Prescriptions , Insurance, Health , Mental Health Services , Telemedicine , Continuity of Patient Care , Drug Prescriptions/standards , Humans , Insurance, Health/legislation & jurisprudence , Insurance, Health/organization & administration , Insurance, Health/standards , Insurance, Health, Reimbursement/legislation & jurisprudence , Insurance, Health, Reimbursement/standards , Mental Health Services/legislation & jurisprudence , Mental Health Services/organization & administration , Mental Health Services/standards , Telemedicine/legislation & jurisprudence , Telemedicine/organization & administration , Telemedicine/standards , United States
6.
Health Aff (Millwood) ; 39(10): 1822-1831, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-695660

ABSTRACT

The recent coronavirus disease 2019 (COVID-19) global pandemic has resulted in unprecedented job losses in the United States, disrupting health insurance coverage for millions of people. Several models have predicted large increases in Medicaid enrollment among those who have lost jobs, yet the number of Americans who have gained coverage since the pandemic began is unknown. We compiled Medicaid enrollment reports covering the period from March 1 through June 1, 2020, for twenty-six states. We found that in these twenty-six states, Medicaid covered more than 1.7 million additional Americans in roughly a three-month period. Relative changes in Medicaid enrollment differed significantly across states, although enrollment growth was not systemically related to job losses. Our results point to the important effects of state policy differences in the response to COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Eligibility Determination/statistics & numerical data , Employment/statistics & numerical data , Insurance Coverage/statistics & numerical data , Medicaid/statistics & numerical data , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , COVID-19 , Cohort Studies , Coronavirus Infections/prevention & control , Databases, Factual , Eligibility Determination/methods , Employment/economics , Female , Humans , Incidence , Insurance, Health/organization & administration , Male , Medically Uninsured/statistics & numerical data , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Retrospective Studies , Risk Assessment , Time Factors , United States
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