In 2020, a White Paper Pandemic-Driven Medicaid and ACA Expansion came out. This paper speaks of the impact the COVID-19 pandemic had made on the healthcare industry, and, specifically, what should be done to minimize the damage taken from it. According to Liu and O’Brien (2020), “this report details expected changes in the composition of national Medicaid and ACA member populations and explores the potential financial consequences of the pandemic on payers” (pp. 2). In another word, the authors have taken an attempt to create a thorough guide for a subsequent extension of the Medicaid and ACA healthcare systems in the face of the virus and the crisis it brought. They provide five strategies for the healthcare workers to help the payers of both systems get through the challenges of the pandemic. This White Papers holds a direct interest in the Administrative and HR policies because its primary goal is to assist in mitigating the payers’ risks associated with healthcare during COVID-19. It aligns the strategies presented in the paper with the challenges the healthcare currently faces, establishing a safe and secure way of managing the damage.
The healthcare system suffered greatly from the pandemic. COVID-19 has exposed severe problems in the population health department even in most developed countries, such as a shortage of supplies and protective equipment, and disintegration of management between the center and the regions. However, one of the most important of these issues is the sluggishness of health care financing systems. A leading role in that problem took the contradictory policies of the authorities and the low efficiency of the health insurance system.
Now, the fight against the pandemic is at its limit, and the continued viability of the healthcare system requires dramatic changes in the management and financing of the industry. Liu and O’Brien (2020) supply that “as people lose their jobs and become ineligible for employer-sponsored insurance, they are seeking new coverage from government-sponsored plans” (p. 8). The White Paper Pandemic-Driven Medicaid and ACA Expansion offers a way to develop and implement these changes through a set of consistent and interdependent steps. It would allow the healthcare organizations to prepare more fully in terms of organizational and administrative regulations, which in turn would provide payers with a better perspective on the system’s work. Moreover, the report also elaborates on the importance of capturing diagnoses more quickly and efficiently to provide high-risk population groups with the care they need. Lastly, the guide strives to improve risk management, which is considered crucial for insurance organizations to properly evaluate their potential business outcomes.
The pandemic has become another important factor demonstrating the relevance of investing in the medical sector and has expanded the range of tasks that the industry in the U.S. has to solve. Shrestha et al. (2020) state that “the pandemic has exposed and exacerbated disparities between low- to middle-income countries and high-income and developed nations, and between the poor and the rich” (p. 6). Liu and O’Brien’s White Paper carefully assess the weak points of the financial aspect of healthcare management and offers various solutions to them.
For example, it suggests expanding the provider network to avoid driving the industry into the bottleneck where it would suffer from the excessive demands it cannot proceed with. Another point of regulation is to prepare for possible payment delays through the exploration of methods to work out appropriate schedules for every healthcare organization specifically. Finally, the prioritization of the patients has to take the lead, which would help the payers identify their diagnoses more efficiently and correctly. Overall, the paper offers a wide range of possible solutions to the current healthcare crisis, and the strategies it brings out map a path to restore and reinforce the U.S. healthcare system.
Liu, J., & O’Brien, D. (2020). Pandemic-driven Medicaid and ACA expansion. Change Healthcare.
Shrestha, N., Shad, M. Y., Ulvi, O., Khan, M. H., Karamehic-Muratovic, A., Nguyen, U.-S. D. T., Baghbanzadeh, M., Wardrup, R., Aghamohammadi, N., Cervantes, D., Nahiduzzaman, K. M., Zaki, R. A., & Haque, U. (2020). The impact of COVID-19 on globalization. One Health, 11, 100180.