Before the coronavirus illness 2019 (COVID-19) pandemic, the health care business was mostly directed toward a value-based arrangement that was moving to focus on cultural determinants of health, according to Bruce Japsen, health care sharing writer at Forbes, during the General Session at the Pharmacy Quality Alliance (PQA) 2020 Annual Meeting.
During the modern COVID-19 pandemic, these prior applications are now being put to the test. The organizations that made advances in areas such as telehealth, home delivery, and other state initiatives before the pandemic are now receiving the rewards of this support already being in place at the time of the crash.
A Value-Based System
Some of these companies are also making attempts to ensure these resources continue to be available to those who have lost their jobs and, thus, potentially their healing insurance as a result of the pandemic.
In this way, the vital support being tapped with building a value-based system and focusing on social determinants of health before COVID-19 are certified as necessary parts of the health care business.
These devices will remain important, as the Kaiser Family Foundation estimates that 20 million people who have lost their job and spent their coverage will be available for coverage under the Affordable Care Act (ACA) through Medicaid or marketplace tax credit.
A value-based system that measures social determinants of health will be important to support these people at a time of great need, with the method being fully tested in the process, according to Japsen.
The Economic Impact
With these shifts and trends, many health care organizations are also fearful of the economic impact, particularly regarding a possible lag in the effects of COVID-19, illustrated by Laura Cranston, RPh, CEO, PQA.
Yet, many publicly purchased health insurance firms are financially quite good, coming out of the first quarter. Presently, they are working to stay ahead of the possible economic outcomes of COVID-19 shortly.
“The key is going to be the differences out there. Whether people are furloughed and keeping their interests, losing their job and going to COBRA, or holding out the healthcare.gov website to understand what they’re available for, there are some key variations in what people will require.
So, to prepare for this, a lot of the health coverage businesses are already starting to shift to make sure they’ve satisfied themselves by introducing new bonus offerings and benefits packages,” Japsen stated.
An instance of this can be seen in the current applications of the insurance company UnitedHealthcare, according to Japsen. UnitedHealthcare got out of the original coverage business following the ACA and was among the major health insurance firms. Presently, following the COVID-19 pandemic, they are now considering getting back into that market.
“They have a great small group market, and small employers and other companies are losing their coverage. The insurance businesses don’t want to lose that game. So, you’re going to see health insurance companies that might lose on one end, try to make it up on the other because they want to keep that profession. It’s in their best due to not just let people lose their coverage,” Japsen said.
The Governmental Sector
Japsen revealed that providers and apothecaries would require to pay close attention this summer to subsisting contracts with health insurance companies. These records may be changing due to new contributions and benefits packages that the security associations will want to provide.
“The policymakers and Congress are recognizing that this pandemic has triggered depression-era job loss. So, the individual sector and the government sector are wanting to make sure that people get an introduction to care, with co-pays and deductibles not getting in the way of that,” Japsen stated. “There are barriers that are being broken down both in the private sector and the state sector to ensure that people can access the care they require.”