Modern Healthcare

The COVID-19 experience and its influence on post-pandemic health policy

- By Benjamin Breier

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. ●

 ??  ?? Benjamin Breier is CEO of Kindred Healthcare, based in Louisville, Ky.
Benjamin Breier is CEO of Kindred Healthcare, based in Louisville, Ky.

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