Healthcare News & Insights

Medicare authorizing telehealth coverage, relaxing rules during coronavirus emergency

To prevent potential spread of the coronavirus, Medicare is now covering the costs associated with doctor appointments done via phone or videoconference. 

As a way to keep up with the demand created by COVID-19 hospitalizations, additional deregulatory steps are either being taken or considered by the Centers for Medicare & Medicaid Services (CMS) to expedite delivering care:

  • Emergency healthcare workers are permitted to screen patients using telehealth outside the emergency room, reducing the number of ER personnel requiring scarce personal protective equipment.
  • The definition of what qualifies as a hospital has been expanded to meet the demand for beds. Services previously reserved for a hospital are expanded to facilities such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels and dormitories. These locations will be used to provide a safe environment for non-COVID-19 patients while allowing room for COVID-19 patients at acute care facilities. The initiative allows hospitals and testing facilities to perform COVID-19 tests at community-based settings outside of a hospital.
  • With patients postponing or cancelling elective surgeries, the 5,000 or so idled surgery centers in the U.S. could be authorized to provide critical but time-consuming cancer therapies, freeing hospital space and staff to focus on the coronavirus.
  • Criteria have been reduced or waived for employing local private practice clinicians and trained staff in specialties who perform nonessential medical and surgical services.
  • Certified registered nurse anesthetists can perform services without the supervision of a physician.
  • CMS has issued a blanket waiver to provide hospital staff with a series of benefits and services, including meals, laundry service for personal clothing and childcare services.

Moves for CFOs to make

As the crisis continues to impact hospitals and health systems, now’s the time for CFOs to start developing a strategic action plan to weather the long-term effects COVID-19 will have on health care.

In a report, Dan Michelson, CEO of Strata Decision Technology, said hospitals will likely have to shift from traditional budgets to a quarter-to-quarter, or even month-to-month, rolling financial forecasting model of doing business.

Three steps to take:

  1. Make sure COVID-19 coding guidelines are being followed and that full diagnosis-related group payments are being received for each bill.
  2. To avoid incurring costs from long-term critical care and to free up capacity for sick patients coming in, move patients off of respirators and into hospital beds as soon as it’s medically safe. If appropriate, recovering patients should be moved to high-quality, cost-effective rehab or longer-term care facilities –  or determine if it’s safe to send them home.
  3. Anticipate post-pandemic patient behavior changes. What’s going to happen when elective surgery volumes return to normal? Will you have to adopt a 24/7 surgery schedule? What procedures will move to telehealth services, and how will you tackle the revenue gap?

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