The Rundown by inforMD | Week of 4.27.2020

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One-Third of Americans Delayed Healthcare Due to COVID-19

A recent survey from Morning Consult and the American College of Emergency Physicians revealed that nearly one in three Americans delayed “adults (29 percent) have actively delayed or avoided seeking medical care due to concerns about contracting the coronavirus (COVID-19).” Approximately 80 percent of respondents worried they may contract the virus from another patient or visitor at the emergency department. Furthermore, 73 percent worried about “overstressing” the healthcare system by going to the emergency department. Overall, respondents agreed it was the federal government’s responsibility to “increase access to protective equipment for emergency physicians” and alleviate the “financial burden on hospitals.”

>> Read More: American College of Emergency Physicians — COVID-19 Survey

CMS to Reevaluate or Suspend Payment Programs

The Centers for Medicare and Medicaid Services (CMS) announced on April 26 that it will reevaluate the Accelerated Payment Program and immediately suspend its Advance Payment Program for Part B suppliers. The Accelerated and Advance Payment (AAP) Programs “are typically used to give providers emergency funding and address cash flow issues for providers and suppliers when there is disruption in claims submission or claims processing, including during a public health emergency or Presidentially-declared disaster.” Since expanding the programs on March 28, 2020, to combat COVID-19, the agency approved nearly 24,000 applications, advancing $40.4 billion in payments to “doctors, non-physician practitioners, and durable medical equipment suppliers.” Effective immediately, however, CMS will not accept any new applications for the Program. Funding is still available through the Paycheck Protection Program, which does not need to be repaid, and an additional $20 billion from the Provider Relief Fund will soon be released.

>> Read More: CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment Program

Decreased Consumer Health Spending Drove Q1 Losses

Decreased healthcare spending is a primary driver of the steep drop in first-quarter economic growth, according to a gross domestic product (GDP) estimate from the U.S. Department of Commerce. Consumer healthcare spending plunged by 18 percent, CNBC reported. A recent report from The Commonwealth Fund echoed these findings, noting that outpatient procedures at ambulatory clinics have fallen by more than 50 percent.

>> Read More: What Impact Has COVID-19 Had on Outpatient Visits?

Healthcare Coalition Urges Congress to Expand Insurance Coverage

Leading healthcare-industry groups have collectively asked Congress to “take immediate action to support employers and workers by protecting and expanding” high-quality, affordable health coverage. The letter, which was published on April 28, was signed by the American Hospital Association, American Medical Association, U.S. Chamber of Commerce, and others. To accommodate the millions who have lost insurance coverage, signatories urged Congress to “provide employers with temporary subsidies to preserve health benefits;” “cover the cost of coverage through … COBRA;” “expand [the] use of Health Savings Accounts;” “open a special enrollment period for health insurance marketplaces;” and increase eligibility for federal subsidies for the health insurance marketplaces.”

>> Read More: COVID-19 Coverage Coalition

Primary Care Linked to Decreased Employer Costs

A recent study published in JAMA Network Open found that “membership-based primary care model” can lower employer cost by 45 percent. The joint study by Collective Health and One Medical observed reductions of $167 per-member, per-month (PMPM) costs “and reductions in avoidable emergency department and hospital visits.” Primary care included both virtual and in-office, and work-site care options. Researchers found that PMPM costs also fell in the areas of specialty care, surgery, prescriptions. Primary care and mental healthcare spending increased by 109 percent and 20 percent, respectively. However, these combined increases, which totaled $21 PMPM, were offset by “lower total medical and prescriptions claims.”

>> Read More: JAMA Network Open Study Between Collective Health and One Medical Finds Virtual + In-office Primary Care Model Linked to 45% Lower Employer Total Cost

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