Employers

Through a new cost-saving provision made possible by the recent COVID-19 relief CARES Act, consumers can now utilize flexible spending arrangements and health savings accounts to purchase cost-effective over-the-counter medications.

Going into the COVID-19 pandemic, previous studies by Milliman found a worsening over the past 5 years of access to inpatient intermediate levels of care and office-based care, said Henry Harbin, MD, leading behavioral health expert and adviser to The Bowman Family Foundation.

In 2 surveys, employers identified efforts to increase availability of virtual care, support employees undertaking greater caregiving roles, and address social and health inequities as a result of the pandemic.

Through the partnership between Innovaccer and Emtiro Health, data utilization will work to delineate and address social aspects known to affect the health of populations nationwide, said Kelly Garrison, CEO at Emtiro Health, and Paul Grundy, MD, chief transformation officer at Innovaccer.

Given the constraints prevalent post-COVID-19, Dr Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design, stresses that it is now more important than ever for the health care industry to prioritize payment reform, value-based benefit design, and novel policy initiatives.

By increasing access and awareness of mental health services, employers can assist in addressing concerns precipitated by pandemic and racial injustice to curb potentially severe and persistent mental illness, said Joe Grasso, PhD, clinical director of partnerships at Lyra Health.

Beyond telework, some notable strategies that employers should consider when managing back-to-school and other leave related concerns among employees include child care benefits and flexible work options, said David Weisenfeld, JD, legal editor and host of a XpertHR podcast.

Hinge Health announced the expansion of its clinical and technical musculoskeletal (MSK) capabilities to cover the full continuum of MSK care. The move will provide the most complete back and joint health solution to employers and health plans.

The COVID-19 pandemic spotlighted the lack of preparation and notable disruptions in the US health care delivery system. To optimally transition to delivering high quality and affordable care, findings from a report by the National Alliance of Healthcare Purchaser Coalitions and the Council for Accountable Physician Practices (CAPP) suggest that enhanced care coordination, greater investment in delivery systems and primary care, and aligning reimbursement with patient outcomes is warranted, said Norman Chenven, MD, vice chairman of CAPP.

Through GoMo Health’s partnership with the Center for Health Technology and Innovation (CHTI) at the American Heart Association (AHA), GoMo, in collaboration with the AHA, has launched the telehealth care coordination solution, known as Concierge Care, a behaviorally-based, patient-centric care solution that can lead to measurable and sustainable population health, said Patrick Dunn, program director of CHTI at the AHA, and Bob Gold, chief executive officer of GoMo Health.

In beginning the first phase 3 clinical trial to examine a vaccine candidate for the coronavirus disease 2019 (COVID-19), Moderna Inc announced that the Trump administration increased funding to expand the trial to 30,000 US participants; employers have considered and some have made it a requirement for employees to sign a waiver to not sue the organization if they are infected by COVID-19 or suffered any injury while working; study finds 1 flu shot can reduce the risk for Alzheimer disease by 17% and 1 pneumonia vaccine before age 75 can reduce the risk by 25%.

In addressing the COVID-19 pandemic, a more active-based approach is warranted among employers to optimize care. Through detailed databases and a greater focus on population health, Paladina Health has promoted this transition to a more informed, value-based health care delivery system, said Kirk Rosin, chief revenue officer of Paladina Health.

In 2 midyear deals reports issued today by PricewaterhouseCoopers (PwC), total US health services deal value and volume were down in the first half (H1) of 2020 compared with H1 2019, with overall global pharma and life sciences sectors also down in H1 2020 compared with the second half of 2019.

Karen Kobelski is the vice president and general manager of clinical surveillance, compliance & data solutions at Wolters Kluwer. She brings more than 25 years of experience to her position, which expands her previous leadership role over the Safety & Surveillance group to also include the Health Language portfolio of data normalization solutions.

Recognizing trends in health care that align with the COVID-19 pandemic and related racial disparities can improve the design of timely and effective strategies by employers to safely return employees to the workplace. Some of these efforts include less wait time for testing results, an improved focus on social determinants of health, and greater accessibility to care, said Lauren Vela, MBA, senior director at Pacific Business Group on Health.

There are 3 key issues that, if addressed by Congress, can optimally assist medical groups and health systems dealing with financial struggles amid the pandemic. These include continued funding to the CARES Act Provider Relief Fund, reinstating the Medicare Accelerated and Advanced Payment program, and permanently lifting waivers on telehealth, said Jerry Penso, MD, MBA, president and CEO of the American Medical Group Association.

Based on findings from our COVID-19 Reopening the Workplace Survey, employers are increasing focus on safety, enhancing well-being programs, and providing flexibility to accommodate employees who may be at-risk or may shoulder a greater caregiving responsibility, said Regina Ihrke, senior director and wellbeing leader of Willis Towers Watson in North America.

In the United States, Gilead Sciences set the price for remdesivir, its antiviral drug that can shorten hospitalization stays for individuals ill with coronavirus disease 2019 (COVID-19), based on insurance factors, and is allowing generic drug makers to create the drug for less in low to middle income countries.

Rita E. Numerof, PhD, is the president of Numerof & Associates, a firm that helps businesses across the healthcare sector define and implement strategies for winning in dynamic markets. For more than 25 years, she has helped executives understand the implications of an evolving healthcare market. Working with leaders in the healthcare space, she has consulted with everyone from top academic and community hospital systems, payers, and Fortune 500 pharmaceutical, device, and diagnostics companies. She is the coauthor of several books, most recently, "Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model" (2016).

With the growing uncertainty of the coronavirus disease 2019 (COVID-19) pandemic and the emergence of services such as telehealth and behavioral health, PwC's Health Research Institute provided 3 spending scenarios for employers managing the insurance market. It projects a 4% to 10% increase in the medical cost trend for 2021 based on these scenarios, said Ben Isgur, MPA, Health Research Institute leader at PwC.

Presented at AHIP’s Institute & Expo Online 2020, panelists discuss in a webinar how greater collaboration of health insurance providers with state and county leaders can ameliorate barriers to access to health care and promote timely interventions to improve health outcomes.

In a webinar presented at the AHIP Institute & Online Expo 2020, experts discussed how data analytics are addressing gaps in health care and providing timely, effective interventions.

Accelerating the shift to value-based care, as well as the growing presence of telehealth, may be potentially beneficial long-term effects of COVID-19 on the health care industry, said Dan Mendelson, MPP, founder of Avalere Health.