The COVID-19 experience and its influence on post-pandemic health policy
One year after the onslaught of the COVID-19 pandemic, it is important to reflect upon how our healthcare system responded to an unparalleled national health emergency and changed course to best meet unique and medically complex patient needs. These lessons learned should influence the development of public policies that extend post pandemic.
Over the past year, overwhelmed hospitals and intensive-care units required new approaches to relieve capacity constraints. These hospitals required solutions that extended their reach and ensured that patients continued to receive the high-acuity level care necessary to recover.
Specialty hospitals, including longterm acute-care hospitals and inpatient rehabilitation hospitals, were able to partner with short-term hospitals to meet public health needs and admit COVID and non-COVID patients with more-intensive needs. These clinical abilities were supported by waivers issued by both Congress and CMS early in the public health emergency. This provided the flexibility necessary for short-term hospitals to meet growing community need.
LTAC hospital service capabilities, which were often misunderstood prior to the pandemic, have met the growing needs of clinicians, health systems, patients and payers. They did so by extending short-term hospital capacity, as well as through clinical expertise specific to a COVID-19 population, which includes patients with significant respiratory and ventilator challenges, multisystem organ failure, or post-intensive-care syndrome.
I am proud of the dedicated clinicians in our nation’s LTAC hospitals and rehab hospitals and their unique ability to meet the substantial and ongoing needs of COVID survivors. Additionally, I am touched each day witnessing the tremendous recovery stories from our hospitals that would not have been possible in lower-acuity settings due to their post-intensive care needs and extreme medical complexity. This was especially true for those COVID patients who required mechanical ventilation.
Now as the COVID vaccine process is putting shots in more than 1.8 million arms daily, with millions more anticipated with the recently approved, and game-changing, single-dose vaccine, we must begin to consider what public health policy should look like after the end of the declared public health emergency, and how we can apply the flexibility and lessons learned to future pandemic policy responses.
At Kindred, we believe that after the public health emergency expires, the regulations defining each unique healthcare setting will once again be in place, preserving the appropriate, medically necessary care for specialized patients.
In looking to develop a stronger health policy strategy going forward, a recent ATI Advisory study, “Role of LTAC Hospitals in COVID-19 Pandemic,” developed recommendations based on experiences in response to COVID-19:
■ In response to the pandemic, hospitals relied on developing clear lines of communication with post-acute partners to ensure more seamless patient transitions. Federal policy must be supported by an organized, local public health response that encourages formalized partnerships, supporting efficient utilization of the full range of acute and post-acute services in a specific region.
■ Reimbursement policy should consider the role that post-acute providers will play in future emergencies, and the manner in which certain providers were able to adjust to meet critical needs. Especially within risk-based models, collaborative patient-centered care and clinical outcomes—not just cost containment—need to be valued and rewarded.
■ Experts agree that the pandemic and isolation have intensified behavioral health issues and the critical need will last for years to come. Clinicians and payers suggest that hospitals with strong behavioral health capabilities would better meet the needs of patients where their complex physical needs are exacerbated by behavioral health issues. This demonstrates an opportunity for health plans and providers to work together to discuss care models that address physical and behavioral health needs in one setting.
This is a critical time for providers and payers to reflect on the past year’s experiences and collaborate with policymakers to develop policies and identify proven strategies so we’re ready for any future public health emergency. ●