Health Care Payment Reforms and Improved Data Sharing Could Help Contain COVID-19

There is increasing political pressure to “reopen America” and return to normal life as people’s fears about COVID-19 wane—whether that reduction in fear is reasonable or not. But in order to successfully reopen the United States and contain future COVID-19 outbreaks, two things will be needed: more testing and improved data sharing.

Two recent papers from the Duke-Margolis Center for Health Policy outline how those changes should be made. First, quick and lasting changes need to be instituted in how health care providers are paid for testing and tracing. Secondly, allow public health programs to work more effectively with private partners, including health care providers and clinical laboratories.

The first report discusses payment modifications that public and private payers can adopt to support COVID-19 test and trace programs. The Duke proposals are built on an April 30 announcement by the Centers for Medicare & Medicaid Services (CMS) about additional payments for COVID-19 testing for Medicare and Medicaid beneficiaries.

Many health care providers and organizations are already building regional capability for testing and tracing COVID-19, their efforts are uneven and are hampered by severe financial difficulties in the wake of the economic turmoil caused by the pandemic.

The report also shares information about payment resources Duke-Margolis believes would help health care providers and encourage them to engage in timely testing and reporting of COVID-19 test results.

“The success of COVID-19 containment as the United States reopens will depend on timely sharing of key information related to testing, contact tracing, and detecting and acting on new outbreaks,” said co-lead author Dr. Farzad Mostashari, CEO of Aledade and former national coordinator for health information technology at the Department of Health and Human Services.

“The nation’s public health system cannot do this alone,” said co-lead author Dr. Mark McClellan, director of Duke-Margolis and former CMS administrator. “We must further engage physicians’ offices, community health centers, pharmacies, and other community health settings, as well as special collection facilities and certain businesses.”

Duke-Margolis’s second report details three steps to improve collaboration, using existing data systems rather than calling for the creation of new ones. These include:

  • Improving commercial lab reporting of demographic data on people being tested for COVID-19;
  • Using available clinical data as a supplement to case investigations; and
  • Enhancing the use of the National Syndromic Surveillance Program and achieving greater transparency in governmental use of the data for decision-making.

Read the full article here.