Anyone can complain about COVID-19—the lockdowns, illness, deaths—the lasting effects speak for themselves.
The U.S. unemployment rate reached 14.8% back in April 2020; the highest rate since the Congressional Research Service began collecting data in 1948. And even though unemployment dropped to 5.4% by July 2021, it remains higher than the pre-pandemic rate of 3.5% in February 2020.
As COVID-19 outbreaks have resulted in hospitalization and ICU patient surges, the CDC estimated “the cumulative hospitalization rate to be 29.2 per 100,000 people, with even higher rates for Medicare-aged individuals (95.5 per 100,000) and adults aged 50-64 (47.2 per 100,000).”
The estimated cost of treating a patient with COVID-19 is more than $20,000, and over $80,000 for patients requiring ventilator support, according to the Kaiser Family Foundation. Furthermore, the American Hospital Association estimates a total four-month financial impact of $202.6 billion in losses for America’s hospitals and health systems.
But unfortunately, hospitals weren’t the only facilities impacted by the pandemic. A 2020 MGMA practice survey reported a 55% decrease in revenue and 60% decrease in patient volume since the onset of the pandemic. As of April 2020, the Commonwealth Fund found that “procedural specialties suffered the greatest volume decline, with ophthalmology down 79%, dermatology down 73%, surgery down 66% and cognitive specialties declining between 30% and 47% in April 2020.”
Ophthalmology ⇩ 79%
Even with a recent rebound, the number of provider visits dropped 25–33% lower than pre-pandemic levels. In August, the Physicians Foundation survey found that about 16,000 physicians (8% of the nation’s 200,000 practicing physicians) closed their practices because of the pandemic’s impact.
That’s not to say that patients stopped seeing providers altogether.
In fact, telehealth visits surged in March 2020 due to broadened telehealth service coverage by Centers for Medicare and Medicaid Services (CMS). An estimated 1.3 million Medicare members received telehealth services in the week ending April 18, 2020, compared to 11,000 members in the week ending March 7.
From October 2019 to October 2020, telehealth claim lines increased a whopping 3,060% nationally, per FAIR Health data.
Due to the continued spread of COVID-19, government organizations and payers (both public and private) have reacted to help those affected by the world health emergency. For instance, CMS telehealth expansion became permanent in December 2020.
CMS required Medicare Advantage organizations to waive certain referral requirements and cost-sharing policies to enable patients to access necessary care. Some state Medicaid programs expanded eligibility and benefits for long-term services and supports for seniors and patients with disabilities.
Many employer-sponsored insurance plans did the following for in-network billing for both COVID-19 and non-COVID-19 health services:
Most recently (September 2021), the CDC and CMS announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. CMS is developing an Interim Final Rule with Comment Period that will be issued in October before these regulations would go into effect.
Learn more about Rivet
With Rivet’s reimbursement software, you’ll see everything that’s happening with your payer contracts, fee schedules, denials and underpayments. Easily work denials by RARC or CARC and apply what you learn to avoid future denials. Plus, check eligibility and provide accurate, up-front patient cost estimates. You can even collect on those estimates!
For more information, download this PDF that breaks down Rivet's products or schedule a demo.