May 12, 2020
by Michael Bagel
In a public health crisis, strong and flexible policy is key to protecting and saving lives as well as setting the framework to overcome adversity. Policymakers must take bold and innovative action to advance the health care system and prepare for a post-COVID world.
The Alliance of Community Health Plans’ (ACHP) nonprofit, provider-aligned member organizations embody the distinctive payer-provider aligned model that is exceptional in delivering high-quality, coordinated and value-based health care. The leadership and on-the-ground experience of ACHP members has inspired promising policy opportunities to turn the page on COVID-19 and improve America’s health care system in the long-term.
1. Make telehealth care permanent.
The COVID-19 experiment to dramatically expand the availability and use of telehealth services has proven to be a huge success, significantly expanding access to affordable care. Individuals receive the health care services they need where and when they want them, including accessing primary care services in a safe and timely way. Telehealth will continue to be an important and regular component of health care delivery. It’s key that policymakers ensure its availability to all consumers as a covered benefit in every federal programs.
2. Advance the next generation of quality measurement.
Delivery of high-quality care has become the expectation; and at no time is it more important than during a public health crisis. Unfortunately, many measures used to evaluate quality are outdated process measures that are simply check-the-box actions. Now is the time to initiate the next generation of quality measurement a streamlined, standardized approach that focuses on patient experience and health outcomes. Information is power – meaningful quality measurement provides consumers more accurate information and empowers wise health care decision-making.
3. Protect consumers’ health data.
Technology is transforming how consumers engage in their health care and assess their personal health. Innovations to enhance care delivery in the current crisis as well as new COVID-19 contact tracing tools have shown the potential for personal health data to be exposed. Strong consumer protections are necessary to protect health privacy and data security. There is an important balance between data sharing for the public good and a person’s right to keep their health data private. New requirements to set standards across this burgeoning industry are critical to protect consumer privacy when the risk may be its greatest.
4. Expand access to mental health services.
COVID-19 has placed significant personal, financial and familial stress on Americans across the country. Universal access to stigma-free, affordable mental and behavioral health services is critical both now and post-crisis. We cannot expect to successfully emerge from this pandemic without providing readily available and accessible services that treat the whole person. ACHP members have demonstrated their ability to affordably deliver mental and behavioral health services via telehealth, embedded in primary care and combined with other social services.
5. Re-think Medicare Advantage network adequacy.
Care delivery under COVID-19 has exposed outdated traditional rules governing Medicare Advantage (MA) network requirements. Antiquated requirements setting time and distance standards do not reflect technological advances, telehealth and the changing needs of consumers. It is time to embrace technology and set a new standard for determining MA network adequacy that is based on both in-person and virtual access to care. This approach would expand the availability of high-quality Medicare Advantage plans to seniors, including in rural areas where the options are limited or unavailable.
ACHP member companies are breaking new ground to address these issues in the communities they serve. But it is clear that advancement of these policies at the national level is central to true transformation. ACHP is committed to working with policymakers and thought-leaders to advance innovative policy solutions as we overcome this pandemic and lead the health care system into the post COVID-world.
Learn more about how ACHP plans are tackling this crisis head on here.