COVID-19 has drastically changed the healthcare landscape for payers and providers as telehealth services are increasingly utilized. Experts discussed how providers are meeting unique challenges posed by the COVID-19 pandemic and long-term benefits of continuing to provide increased access to high-value care.
According to Mark Fendrick, MD, director of V-BID and co-editor-in-chief of American Journal of Managed Care® states that “There are more clinically nuanced ways of coming out of the COVID-19 pandemic.” To capitalize on the opportunities the pandemic presents for improving healthcare efficiency, Fendrick outlines the following strategies:
- Base reimbursement on patient-centered outcomes using alternative payment models, reduce or cease payment for known low-value care and increase reimbursement for high-value services
- Harness the power of analytics by using electronic health records (EHRs) to make it easier to order high-value care while discouraging the use of low-value care with alerts
- Align patient cost-sharing with the value of the underlying services; increase patient cost on low-value care and reduce out-of-pocket cost on high-value services
- Utilize the V-BID model, to enhance coverage and target high-value care without raising deductibles or premiums.
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(Source: Gianna Melillo, August 11, 2020)