Templates & Toolkits | Apr 8, 2020

Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis

Anne Karl, Jocelyn Guyer and Avi Herring, Manatt Health

The COVID-19 pandemic is causing dramatic changes in utilization that threaten the financial stability of providers and may jeopardize access to care during and after the national emergency. With elective cases generally cancelled, hospitals have sharply lower utilization and revenue. Some hospitals in hotspots are seeing a surge in COVID-19 related usage, which may offset some or all of the revenue decline and in some cases increase their costs. In addition, many other providers that rely on face-to-face visits—including primary care, behavioral health, and providers of long-term services and supports—are seeing large utilization declines due to social distancing requirements. Federal and state governments have acknowledged and responded to the financial challenges facing providers in several different ways. While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, this toolkit identifies more immediately available tools that can help ensure payments continue flowing to providers despite substantial utilization changes.


Expert Perspectives

May 29, 2020

Is COVID-19 the End of Fee-for-Service Payment?

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.

May 19, 2020

Responding to COVID-19: State-Based Marketplaces Take Action

As the COVID-19 crisis began to take hold, state-based marketplaces (SBMs) were quick to respond to the first nationwide public health emergency since the Affordable Care Act created new coverage options in states. Informed by conversations with seven SBMs that established an SEP—Colorado, Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington—this expert perspective highlights strategies that successfully drove enrollment, including: leveraging their SBM status to quickly and efficiently operationalize customer service in a new remote environment, directly engaging with existing customers as well as reaching out broadly to new ones, and adapting outreach tactics based on new insights regarding audience needs and behaviors to reach them most effectively.