The recommendations came in letters from Jacqueline W. Fincher, MD, MACP, president of ACP, to the presidents and CEOs of the Blue Cross Blue Shield Association, UnitedHealth Group, the National Association of Insurance Commissioners, and America’s Health Insurance Plans.
“If private payers do not join with the Centers for Medicare & Medicaid Services to provide physician practices with the critical support they need in this unprecedented crisis, hundreds if not thousands of practices across the country may be at real financial risk of closing, leaving a critical shortage of healthcare services at a time we can least afford it,” Fincher wrote.
The ACP’s recommendations include:
· Extending telehealth and telephone flexibilities paid at the same rate as in-person services regardless of platform
· Direct financial support including reimbursing waived patient cost-sharing responsibilities and direct payment relief payments
· Developing more alternative payment models that move away from inconsistent fee-for-service, especially those offering fixed, periodic prospective payments
· Extending and expanding current administrative flexibilities, including broad reprieves from prior authorization requirements, which take time and resources away from patient care
“These important changes will enable physicians and their care teams to adapt to the new environment and deliver patients the care they need in a manner that helps to protect their safety, as well as those around them,” Fincher wrote. “Practices will not recover from this crisis overnight. At a minimum, these changes should extend at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend further based on the experiences of patients and physicians.”