The coronavirus pandemic of 2020 has created a seemingly paradoxical scenario for the finances of health care providers. While states were rushing to build field hospitals to prepare for a surge of COVID-19 patients, traditional revenue streams for providers completely dried up: elective procedures were suspended and social distancing protocols limited the number of patients in office settings. A public health crisis became a health care crisis, as COVID-19 revealed the faults in the way necessary and critical health care services are paid for in America.
Medicaid Enhanced Provider Payment Strategies and COVID-19: Questions and Answers
Anne Karl, Manatt Health
As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government has acknowledged the financial challenges facing providers through supplemental funding included in the three federal stimulus bills enacted to date–the Coronavirus Aid, Relief, and Economic Security Act (CARES Act); the Families First Coronavirus Response Act; and the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020. In addition, several states have submitted Section 1115 waivers requesting CMS approval to establish “disaster relief funds,” paid for with Medicaid dollars, to further assist providers.
While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, more immediately available tools can help ensure payments continue flowing to providers despite substantial utilization changes. This Q&A provides a moment-in-time update in response to questions SHVS has received regarding the April 9 Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis Webinar and corresponding Toolkit.