On January 31st, 2020, Alex M. Azar, II, the Secretary of the Department of Health and Human Services (HHS) declared a Public Health Emergency (PHE) in response to the rising Covid-19 virus. This action was taken to combat the increasing cases of Covid-19, spawning multiple flexibilities for Medicare, Medicaid, and other private health insurance.
But with the PHE expected to end on May 11th, 2023, healthcare professionals are mindful and concerned that some of the opportunities available during the pandemic may not be made permanent.
There are multiple implications when ending the Public Health Emergency, most of which will grant the federal government the opportunity to waive or change specific requirements in an assortment of health plans such as Medicare and Medicaid. This will not only leave thousands without coverage, but it could also impact health premiums while altering treatment waivers and other relaxed rule changes issued during the pandemic. Not to mention the numerous telehealth benefits that will be affected once the PHE ceases.
This guide will provide a brief overview of what the end of the Public Health Emergency will look like and how it will affect your PALTC practice.
Public Health Emergency End will Bring Medicare Redeterminations
One key benefit to come from the Public Health Emergency was additional funds for hospitals and PALTC practices nationwide. The PHE initiated these extra collectives in hopes of expanding the range of care for patients everywhere during the pandemic. This led to a 20% increase in Medicare payment rate while treating Covid-19 patients, an increase that will require countless redeterminations to determine who still qualifies for coverage, and an increase in premium rates once the PHE ends.
Once the PHE ends, a redetermination process will begin for patients who received care during the pandemic. This process of redetermination is already complicated under normal circumstances, but when placed within the sheer scope of the pandemic, it’s seemingly impossible. Since it’s been three years since the Public Health Emergency began, most individuals have probably changed their location of residence, making the task of finding them all the more challenging. In addition, a process of this magnitude is unprecedented for practices nationwide, resulting in the processing of millions of patients.
Even though the end of the Public Health Emergency might represent a step forward, it could actually end up pushing some patients further behind.
For more information on Medicare redetermination, check out our past post here.
Covid-19 Waivers and Flexibilities
During the pandemic, the Public Health Emergency provided relaxed rulings and waivers for certain forms of care supplied by PALTC practices. The PHE implemented these flexibilities to broaden the scope of care delivery and offer coverage for those who were left uninsured. This, of course, resulted in a surplus of patients for practices everywhere. But with the emergency coming to an end, many PALTC practices are already reverting back to pre-pandemic processes and standards. If they haven’t already, copay waivers will cease, along with provider licensing rule waivers, resulting in providers needing to be licensed in each state they provide care for.
There is, however, a silver lining.
If a payer has had a positive experience during the emergency, say, an improvement in patient outcome, they can make a permanent change to include certain rule relaxations and waivers. This, along with certain telehealth flexibilities, will transition over from the Public Health Emergency into your day-to-day services. This leads us to...
Impact on Telehealth Services
One particular form of care that became popular during the Public Health Emergency was telehealth services. And for a good reason, too. As the impact of the virus on care delivery grew, PALTC practices everywhere had to evolve to provide viable care to their patients. This evolution involved using telehealth to provide care virtually and reduce outside exposure to the Covid-19 virus. Telehealth, also known as telemedicine, helps practices deliver quality care wherever their patient is in their cycle of care.. And as the pandemic continued, many patients found comfort in telehealth, many preferring it over face-to-face contact appointments.
Even with the end of the PHE on the horizon, the future of telehealth seems stable. Just recently, President Biden signed a $1.7 trillion Omnibus bill to extend telehealth services and hospital-at-home waivers for another two years. Not only is this a success for telehealth services, but the bill is also set to reduce the 2023 Medicare payment cuts from 4.5 percent to only 2 percent.
As the PHE comes to an end, many practices and their patients are reassured that telehealth services are here to stay, hopefully for a long time to come.
Public Health Emergency End Wrapped-Up
It’s a different world than it was three years ago. The world has changed. Healthcare has changed. WE have changed. And in change, we find a new future in front of us.
When the Public Health Emergency ends, the world will change once again. Vaccines will be sold for profit instead of care as redeterminations will fuel the gears of Medicare providers for the months to come. Telehealth services will persevere for another two years with the help of President Biden’s Omnibus bill.
Even as we step into a new normal, make no mistake; change is coming. And it’s coming soon.