As clinicians and other health care providers face significant continuing revenue shortfalls due to COVID-19, they are trying to adapt. They have reoriented their workforces, modified facilities, developed telehealth, and community-based care, and reimagined the best way to deliver care for all their patients—including those who have tested positive for the virus. In the midst of this national crisis, provider organizations are finding that Fee-For-Service payment offers no backstop when utilization drops, forcing many practices to close their doors and preventing families from being able to access critical health care services.
To ensure health care providers can meet the needs of their patients, the Duke Margolis Center for Health Policy, Families USA, and United States of Care have released a proposal that will provide financial support for health care providers through the COVID-19 Health Care Response and Resilience Program. This program aims to protect providers’ ability to provide high-value care to families both during and after the pandemic by building on reforms in care that are working now and should remain after the pandemic and helping providers move away from fee-for-service payment. The ultimate goal is to reform health care provider payment and organization so that it is more stable and effective in future public health crises.
The organizations are sending their proposal to Congress to urge them to include the following priorities in the next COVID-19 legislative package:
- Provide COVID-19 Health Care Relief, Response and Resiliency (RRR) Payments to primary care, specialty care, and Medicaid providers, Community Health Centers and hospitals, particularly rural hospitals, and support those providers to move into Alternative Payment Models
- Expand Telehealth Coverage
- Expand Site-Neutral Payments
- Enhance Data and Transparency on the Quality and Cost of Care
To date, the proposal has received support from six organizations, including the American Academy of Family Physicians, Pacific Business Group on Health, and Consumer Action. The report also received support from former CMS Administrators and Health Care Leaders who sent a letter of support to Congress, including Don Berwick, Tom Daschle, Bruce Vladeck, Gail Wilensky, Bill Frist, and Tom Scully.
“Changing health care payment and delivery will allow for a stronger COVID response and will ensure resiliency for health care providers now and in the foreseeable future,” said Frederick Isasi, Executive Director of Families USA. “This is what the health care system—and the families it serves— have been lacking for far too long. An improved compensation structure will create more solvent practices that are better equipped to meet each patient’s unique needs and to provide the high quality, affordable health care and good health that our nation’s families deserve.”
“Fee-for-service payment has not worked during the pandemic, and we’ve also learned that it doesn’t support many changes in care that we’d like to keep after the pandemic,” said Mark McClellan, MD, Ph.D., director of Duke-Margolis Center for Health Policy and former commissioner of the Food and Drug Administration. “Providers are hurting financially at a time when they are not only managing surges in COVID-19 patients but also building new care models that support patients at home and in the community, and participating in public health efforts contain the pandemic. The COVID-19 Health Care Response and Resilience Program gives providers financial relief and support to address the pandemic, and the ability to emerge from the pandemic with better health care through value-based payments.”
“We know that people want the assurance that the health care system is there when they need it, now and after the pandemic. In addition to racial and socioeconomic inequities, COVID-19 has shown that our current way of paying providers in a fee-for-service health care system is even more precarious than we thought, said United States of Care Executive Director Emily Barson. “United States of Care included the COVID-19 Health Care Response and Resilience Program in our recent federal recommendations because it stands to be a catalyst for changing how health care in America is paid for and delivered. By changing how providers are paid, rewarding value instead of volume, medical professionals will get to practice medicine the way they want: keeping people healthy rather than just treating people when they are sick.”
Media Availability – to arrange an interview or conversation on background about the A COVID-19 Health Care Response and Resilience proposal, please contact the media representatives listed below.
Patricia Shea Green, Duke Margolis Center for Health Policy
[email protected]; cell: 301-520-6482
Lisa Holland, Families USA
[email protected]; cell: 202-236-6887
Chris Fleming, United States of Care
[email protected]; cell: 202-631-0929