» The Official End of the Pandemic Health Emergency (PHE)

The impact of the end of PHE will be immediate and underestimated; unfortunately, it is looking like it will destabilize the already broken health industry.  See below two things to make note of!

1. Cost Shifting to Private Insurers:

It is true that the official end of the Pandemic Health Emergency (PHE) will likely result in some changes in the way COVID-19 treatment is covered by insurance providers in the United States. As you mentioned, access to COVID-19 testing, vaccines, and treatments with no out-of-pocket costs for uninsured individuals will continue through 2024, thanks to federal funding.

However, enrollees in commercial plans, Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) may see increased cost-sharing for COVID-19 tests and treatments, as the cost burden for these services shifts from the federal government to private insurers. This means that insurance providers may need to cover more of the cost for COVID-19 tests and treatments, which could lead to higher revenues for insurers.

At the same time, increased cost-sharing for COVID-19 tests and treatments could result in higher out-of-pocket costs for consumers. This could potentially create a financial burden for individuals and families, particularly those who are uninsured or underinsured.

Additionally, hospitals and physicians may continue to experience bad debt related to the provision of COVID-19 care, as some patients may be unable to pay their out-of-pocket costs or may not have insurance coverage. This could be a particular challenge for hospitals and healthcare providers in areas that have been hard hit by the pandemic.

It’s worth noting that the specific details of how COVID-19 treatment will be covered by insurance providers in the post-PHE period are still evolving, and will likely depend on a range of factors, including ongoing public health efforts to control the spread of the virus and the impact of COVID-19 on the broader healthcare system.

2. Telehealth Flexibilities Continued:

Expanded reimbursement for telehealth services: The Centers for Medicare and Medicaid Services (CMS) expanded Medicare reimbursement for a broader range of telehealth services, including virtual check-ins, e-visits, and remote patient monitoring.

Lifting of geographic restrictions: The CMS temporarily waived restrictions on telehealth across state lines, allowing providers to deliver care to patients in other states.

Expanded scope of telehealth services: The PHE allowed for additional services to be delivered via telehealth, such as mental health counseling, substance abuse treatment, and hospice care.

Increased use of telehealth technologies: The PHE led to increased adoption of telehealth technologies, such as videoconferencing and remote patient monitoring, which allowed providers to deliver care remotely and reduce the risk of COVID-19 transmission.

Reduced regulatory barriers: The PHE temporarily reduced regulatory barriers to telehealth, allowing for easier adoption and use of telehealth technologies.

Posted by John Hansbrough in Healthcare, Healthcare Spending, Human Resources, Legislation, Telehealth