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 has caused 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. Between March and August 2020, a combination of lost revenue related to fewer elective procedures and emergency department/outpatient encounters, and higher costs related to COVID-19 has put many hospitals in a precarious financial position. In addition, many other providers that rely on face-to-face visits have seen large utilization declines due to social distancing requirements, with outpatient visits falling 60 percent in April 2020. As of July 2020, outpatient visits remain 10 percent below the pre-COVID-19 baseline, even after accounting for the increased use of telemedicine. Most of the Provider Relief Fund dollars have been distributed, yet providers are still experiencing lost revenue and increased costs related to COVID-19. Under any scenario, Medicaid payment strategies—especially for providers serving high numbers of Medicaid patients—remain a critical tool for states to support providers as new COVID-19 hotspots emerge and utilization patterns change. This toolkit has been updated as of August 26, 2020 to reflect more recent federal guidance and examples of specific strategies states implemented between April and August 2020.
SHVS also hosted a companion webinar, the slide deck for which has been updated as of August 26, 2020.
A range of policy proposals to cut federal Medicaid funding under consideration by Congress could profoundly reshape the Medicaid program. Although the specific details of these proposals have not yet been defined, many entities are actively analyzing the possible effects on state Medicaid enrollment and spending. This expert perspective highlights the national 50-state analyses of Medicaid cuts that have been released. SHVS will continue to regularly monitor published estimates and update this expert perspective.
The budget reconciliation process is continuing to move forward in Congress and includes developing proposals in the House to identify $880 billion in federal savings over the next ten years, the vast majority of which will need to come from Medicaid. To support states in informing and validating their own fiscal and program impact estimates of federal policy changes, Manatt Health has developed, with support and input from State Health and Value Strategies, a new toolkit providing national and state-by-state data on the potential impact of key cuts under consideration in Congress. This expert perspective provides an executive summary of the toolkit.
Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, widely expected to reduce enrollment and federal Medicaid funding to states. A variety of state-level estimates have been released, which can be helpful for states as they consider how various policy proposals might impact their Medicaid programs. This expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update this expert perspective.
