Changes to Organizational Policies and Guidelines

Policies and guidelines (including furloughs) that have been implemented because of COVID-19.

(11/30/20) Thousands of Doctors’ Offices Buckle Under Financial Stress of COVID
This article from Kaiser Health News reports that recent data suggests thousands of medical offices across the United States have closed in response to financial pressures from the COVID-19 pandemic. These closures are exacerbating shortages of providers in many rural locations across the nation.

(11/27/20) Hospitals Race to Set Vaccine Priorities for Health-care Workers
With a COVID-19 vaccine appearing imminent, health care systems throughout the United States are creating plans for internal distribution of a vaccine. The United States has 21 million health care workers, likely requiring prioritization even among health care workers for who will receive a vaccine given expectations of fewer doses being available initially.

(11/25/20) Near Crisis, Some Hospitals Face Tough Decisions in Caring for Floods of Patients
Hospitals in areas with critical capacity issues due to high cases and hospitalizations for COVID-19 are required to make difficult decisions in caring for patients. While data has not been publicly released to confirm, public health experts suspect hospital crowding is forcing crises in triage decisions.

(11/24/20) Ohio Hospital’s “Helping Hand” Initiative Gives Nurses Extra Help
This article discusses a move from a hospital in Middletown, Ohio that has utilized administrative staff to help take over non-clinical nursing tasks in order to allow nurses more time with patients.

(11/17/20) How Practices Can Advance the Implementation of Integrated Care in the COVID-19 Era
This issue brief from The Commonwealth Fund details how organizations can utilize integrated care to improve patient outcomes in the era of COVID-19. Although the data for the study was collected prior to the pandemic, the findings may be especially relevant to improve outcomes in the pandemic.

(11/15/20) Doctors Are Calling It Quits Under Stress of the Pandemic
An article from The New York Times covering the impact of the COVID-19 pandemic on physicians and nurses across the United States. Recent surveys have found that many older physicians are retiring earlier than they anticipated, and many smaller clinics are closing due to the financial burden of staying open.

(11/11/20) ‘We’re Being Left Behind’: Rural Hospitals Can’t Afford Ultra-cold Freezers to Store the Leading COVID-19 Vaccine
This article from STAT highlights fears rural hospitals are vocalizing over the difficulty transporting and storing the leading COVID-19 vaccine, which Pfizer has announced will require ultra-cold freezers and cannot be refrozen upon thawing.

(11/09/20) The Challenge in Tracking Unemployment Among Health Care Workers and Why It Matters
A journal article published in JAMA from researchers at the University of Washington Center for Health Workforce Studies explains the difficulties associated with tracking unemployment in health care workers. The authors describe how having accurate data on the health workforce is essential to direct policy and can help produce better results for health care providers and their patients.

(11/06/20) 58,300 Healthcare Jobs Added in October; Hospitals See Job Gains
For the sixth consecutive month, the health care sector has added jobs following the drops in employment amid initial pandemic-related shutdowns. Of these jobs, the majority came from hospitals, followed by physician offices and dental offices.

(11/06/20) Mayo Clinic, Banner Health Say They Have Thousands of Job Openings
Both the Mayo Clinic and Banner Health are seeking workers for clinics in the southwestern United States, primarily Arizona and surrounding states. Nursing is in the highest demand, as well as support positions. Many hires have been made on a per diem basis to help address the COVID-19 pandemic.

(10/27/20) COVID-19 and Health Disparities: Insights From Key Informant Interviews
Another addition to the Health Affairs Blog series, “Higher Health Care Value Post COVID-19.” In this blog post, the authors discuss the results of key informant interviews about health disparities in the context of the COVID-19 pandemic, and how that impacts value in health care delivery.

(10/27/20) The COVID-19 Pandemic Can Help Us Understand Low-Value Health Care
Delivering health care with a higher risk of harm compared to benefit can be a result of overuse of health care. Care like this can be low value and wasteful compared to care which provides proportional benefit to its cost. This blog post helps identify low value care in the context of COVID-19, and encourages further evaluation of the role of low value care before, during, and after the pandemic.

(10/23/20) Spillover Effects of the COVID-19 Pandemic Could Drive Long-Term Health Consequences for Non-COVID-19 Patients
With priority for treatment and procedures going to COVID-19 patients and related services, many non-COVID-19 patients are choosing to delay treatments or may not have treatment available to them. This potentially leaves negative long-term consequences for children, patients with chronic conditions, and patients at risk for cancer, among others.

(10/21/20) Opportunities to Improve Value in Health Following the COVID-19 Pandemic
This blog post from the Health Affairs series “Higher Health Care Value Post COVID-19” discusses the learning opportunities for health care in the United States taken from the COVID-19 pandemic. These opportunities are presented as avoiding wasteful and unnecessary treatments and changing payment methodology, among others.

(10/21/20) Applying Value Assessment to the Health Care Sector for COVID-19
This blog post from the Health Affairs series “Higher Health Care Value Post COVID-19” seeks to assess the opportunity costs, cost-effectiveness thresholds, and dominance and cost-savings potentials from changes to health care experienced in the COVID-19 pandemic.

(10/19/20) Trends in Overall and Non-COVID-19 Hospital Admissions
This issue brief from the Kaiser Family Foundation covers trend data for hospital admissions, both overall and exclusive of COVID-19. This data can be helpful in estimating the impact of changes to admissions and services on the long-term financial health of hospitals in the United States.

(10/16/20) Social Work and Tele-behavioral Health During COVID-19
The Behavioral Health Workforce Research Center at the University of Michigan has released a research brief covering the use of tele-behavioral health services during the COVID-19 pandemic. The findings of the research include significant increases in use of tele-behavioral health and organizational telehealth capabilities.

(10/16/20) How Virtual Care Can be Refined to Reach Those Who Need it Most
In this article, multiple experts are interviewed for their perspective on how to improve access to health care utilizing telehealth services and technology. Although virtual care offers some benefits to address issues with physical access to care, there are still issues with ensuring the technology is distributed and accessible equitably.

(10/15/20) CMS Will Reimburse for 11 New Telehealth Services During the Public Health Emergency
New guidance from the Centers for Medicare and Medicaid Services has added 11 additional services to the list of reimbursable Medicare telehealth services. These additional services expand into such practices as neurology and both cardiac and pulmonary rehabilitation services.

(10/14/20) As Telehealth Surges, Dermatology Brings Experience With Access and Sustainability
Utilization of telehealth technology has expanded rapidly with the onset of the COVID-19 pandemic, with apparent long-term staying power. This blog post from Health Affairs covers some of the opportunities and challenges for telehealth continuing forward based on the use thus-far in the pandemic.

(10/13/20) Top 3 Concerns with the 2021 Medicare Physician Fee Schedule Rule
This article discusses some of the changes proposed for the 2021 Medicare Fee Schedule, which has some provider groups worried. These proposed changes include cuts to some specialty payments, changes to telehealth services eligible for reimbursement, and new quality reporting requirements.

(10/13/20) 3 Health System Execs on Staffing Challenges, Advice to Peers
Reorganization of hospitals and clinics to respond to the needs of the pandemic have also forced staffing adjustments to health systems across the country. This article from Becker’s Hospital Review covers interviews with three health system executives discussing their strategies and advice to meet these demands.

(10/09/20) Distributing Provider Financial Aid to Create a More Efficient, Equitable System
This blog post from Health Affairs advocates for reforming the methodology for distributing emergency relief funds, targeting issues relating to the emergency COVID-19 funding. The authors argue wealthier hospitals that are better able to withstand revenue disruptions received too much funding compared to less wealthy health care providers.

(10/08/20) How the COVID-19 Pandemic Has Affected Provision of Elective Services: The Challenges Ahead
With the Center for Medicare and Medicaid Services releasing guidelines in March recommending the postponement or cancellation of elective procedures, many states and organizations across the country put an end to these services. This blog post featured in Health Affairs discusses some of the impacts of this disruption, from revenue problems to adverse impacts on patients.

(10/08/20) Limitations of the Program for Uninsured COVID-19 Patients Raise Concerns
This article covered by the Kaiser Family Foundation covers the policy implications of the federal provider relief program intended to cover uninsured individuals who are hospitalized or seek treatment for COVID-19. A significant limitation of the program is that providers are not guaranteed reimbursement, as it is contingent on available funding, leading many providers to either not participate entirely or withdraw after previously participating.

(10/02/20) Higher Health Care Value Post COVID-19
Health Affairs has assembled a group of experts to discuss some of the light in the darkness of the COVID-19 pandemic, specifically relating to the ways in which value can be increased from the changes forced by the pandemic.

(10/01/20) To Free Doctors From Computers, Far-Flung Scribes Are Now Taking Notes for Them
As COVID-19 upended traditional medical visits, telehealth and other remote services saw drastically increased utilization. This includes remote scribing, where scribes take medical notes for health care providers from a remote location, and add them to the patient’s electronic health record, without risking COVID-19 exposure.

(09/30/20) Health Equity and the Future of Nursing, Post-COVID-19
This blog post featured in Health Affairs discusses the important roles nurses can take to advocate for important changes to health care based on what has been learned from the COVID-19 pandemic. Nurses are among the most trust health care providers and can use this position to advocate for reforms supporting increased health equity.

(09/24/20) The Impact of the COVID-19 Pandemic on Hospital Admissions in the United States
This research article published by Health Affairs covers the changes to hospital admissions in the United States as a result of the COVID-19 pandemic. This study found significant decreases in non-COVID-19 related hospital admissions throughout the pandemic, albeit lower at the onset than during the summer. These decreases are most pronounced in majority-Hispanic communities.

(09/22/20) Rural Hospitals Teeter on Financial Cliff as COVID Medicare Loans Come Due
A joint-reported article from Kaiser Health News and NPR highlighting the financial issues many rural hospitals are facing due to the COVID-19 pandemic. As payment for medicare loans given months prior are becoming due, many rural facilities are not in a position to repay and could use even more assistance.

(09/22/20) Financial Fallout From COVID-19: 9 hospitals Laying Off Workers
A list of hospitals laying off health care workers since August. The impact of COVID-19-related service interruption and the subsequent decrease in in-person visits is having long-term negative impacts on the financial situations of many clinics in the United States.

(09/16/20) How to Improve the Surgery Backlog During COVID-19
This article from the University of Michigan Health Lab highlights some new research on managing the backlog in surgery caused by the early prohibition on elective procedures in response to the COVID-19 pandemic. In order to maintain quality while working through the increased demand, the authors suggest continuing use of telemedicine as possible, expanding operating room and surgery capacity temporarily, and being open with patients about the costs, as patients may be under increased financial pressure.

(09/15/20) Promoting Equitable Access to COVID-19 Vaccines—the Role of Medicaid
A blog post featured in Health Affairs covering the need to ensure medical clinics create dedicated processes, spaces, and staff to administer COVID-19 vaccines. Ensuring Medicaid provides fair reimbursement could also help ensure widespread adoption by providers and increase effectiveness of vaccination promotion.

(09/15/20) Some Urban Hospitals Face Closure Or Cutbacks As The Pandemic Adds To Fiscal Woes 
Safety net hospitals are constantly struggling to survive in non-pandemic times and their issues are only magnified in today’s circumstances. This article from NPR dives into what is causing more of these hospitals to shut down and what results from their closure.

(09/14/20) School Closures Cut a Critical Line to Dental Care for Poor Students
An article from The New York Times covering how school closures related to COVID-19 have negatively impacted access to dental care for poor students across the United States. Dental visits in schools are far more important for lower income students, who are disproportionately impacted by school closures.

(09/04/20) Healthcare Jobs Grew by 75K in August as Industry Recovers from Job Losses Due to COVID-19
This article in Fierce Healthcare covers job gains announced for the month of August, which saw significant gains in the health care industry, however fewer compared to the gains in July. 75,000 jobs were added, with physician offices and dental practices making the largest gains.

(09/03/20) 20% of Clinicians Considering Leaving Primary Care in Light of COVID-19-linked Financial Challenges: Survey
An article discussing some troubling findings from a new survey from the Primary Care Collaborative. The survey found that as many as one-fifth of clinicians are considering leaving primary care practice, as well as nearly one-tenth of practices unsure of their ability to maintain operations for another month due to COVID-19 related financial struggles.

(09/01/20) 26 Hospitals Bringing Back Furloughed Employees
A routinely updated list covering the hospital and health care systems that have brought back health care workers furloughed since June.

(08/26/20) COVID-19 Underscores the Need for Digital Quality Measurement
This blog post from Health Affairs highlights the importance of digital quality measurement, a method to combat weaknesses to developing clinical guidelines shown throughout the COVID-19 pandemic. Utilizing digital quality measurement can enable better care with less burden on clinicians.

(08/24/20) Financial Fallout from COVID-19: 38 Hospitals Laying Off Workers
As the COVID-19 pandemic continues to wreak havoc on budgets for hospitals, across the country layoffs and furloughs are continuing to be a problem many health care workers are facing. Low patient volume, lack of elective procedures, and increased costs of operation are causing significant hardship for these clinics.

(08/22/20) Rural Hospitals Are Sinking Under COVID-19 Financial Pressures
This story from NPR discusses the impact of COVID-19 on rural hospitals throughout the United States, many of which were already facing significant funding issues prior to the pandemic. Rural hospitals depended on federal aid early in the pandemic, but are now facing a crisis point with immediate need and little indication of any more aid to come.

(08/20/20) State Data and Policy Actions to Address Coronavirus
A frequently updated issue brief from the Kaiser Family Foundation outlining the many actions states have taken to address the COVID-19 pandemic. This brief includes both state health policy and guideline changes, as well as other regulations.

(08/17/20) Nearly 17% of Nurse Practitioners Furloughed Due to COVID-19 & 5 Other Survey Findings
A new survey from the American Association of Nurse Practitioners found that 17% of nurse practitioners in the United States were furloughed due to the COVID-19 pandemic, with 4% still reporting being furloughed at the end of July. Beyond this, nurse practitioners reported decreases in income, decreases in hours worked, and issues with receiving adequate personal protective equipment supplies.

(08/12/20) Community Resilience for COVID-19 and Beyond: Leveraging a System for Health Care and Social Services Integration
A blog post featured in Health Affairs covering how Contra Costa Health Services provided health care that integrates social services and allowed this county-based safety-net health system in the San Francisco Bay Area of California to effectively respond to the COVID-19 crisis.

(08/11/20) How to Ensure COVID-19 Doesn’t Delay Value-Based Care
A blog post featured in Health Affairs discussing the potential long-term impacts of COVID-19 on health care payment reform and quality improvement. While the Centers for Medicare and Medicaid Services have allowed increasing flexibility to deal with the pandemic, these may be detrimental to health care service in the long term.

(08/04/20) Health Care Workforce Reform: COVID-19 Spotlights Need for Changes to Clinician Licensing
The COVID-19 pandemic has compelled state and federal policymakers to acknowledge that clinician‐​licensing laws block access to care. This report addresses needs for changes to clinician licensing. Some topics discussed include: right skill vs wrong skill, direct government licensing, and innovative education and certification.

(08/03/20) How COVID-19 is Transforming Healthcare Recruitment
An article discussing a new report from Jordan Search Consultants covering changes in health care recruitment strategies in response to the COVID-19 pandemic. Even as hospitals and clinics across the United States were facing furloughs and revenue losses, the necessity of recruiting key positions remained.

(08/03/20) 19 Hospitals Bringing Back Furloughed Workers
A routinely updated list from Becker’s Hospital Review covering health care systems that are bringing back furloughed workers. Many are based in the Northeast, where elective procedures are resuming following low COVID-19 infection.

(07/29/20) Addressing Barriers to Care for Patients With Limited English Proficiency During the COVID-19 Pandemic
A blog post featured on Health Affairs discussing the difficulties some patients have receiving care that meets their language proficiency. Recommended solutions to this issue include teaching medical students how to use remote interpreter services and inform their patients of language assistance rights, as well as changes to online patient portals to assist those with limited english comprehension.

Alliance for Health Policy 2020 Signature Series Part I: Summit: Disruptors and Transformers:
(07/23/20) Keynote: A Conversation on Innovative Research Approaches to Advance Our Understanding and Treatment of COVID-19
(07/23/20) Using Data to Disrupt the Spread of COVID-19 and Prevent Future Pandemics

See more information and all parts of the series here
The Alliance for Health Policy is hosting a Summit to provide expert analysis and perspective on the short and long-term impacts of the COVID-19 pandemic on the United States health system. The theme for the first part of the series is disruptive and transformative impacts of the pandemic.

(07/22/20) PCC Webinar: The Secret Sauce: How Some Primary Care Practices Are Surviving COVID-19
A webinar from the Primary Care Collaborative discussing the ways in which some primary care practices are implementing new and innovative strategies to meet the challenges brought by the COVID-19 pandemic.

(07/20/20) Addressing Racial Health Disparities In The COVID-19 Pandemic: Immediate And Long-term Policy Solutions
A blog post on Health Affairs discussing the racial disparities emerging in the COVID-19 pandemic, as well as strategies to ensure health professionals are adequately prepared and trained to provide better, disparity-addressing care to their patients.

(07/20/20) State Data and Policy Actions to Address Coronavirus
A frequently updated issue brief from the Kaiser Family Foundation outlining the many actions states have taken to address the COVID-19 pandemic. This brief includes both state health policy and guideline changes, as well as other regulations.

(07/18/20) The Coronavirus Means Doctors, Nurses and PAs Are Essential Workers — Until They Get Laid Off
An opinion piece from a physician assistant discussing the way in which the COVID-19 pandemic has impacted her and many other health care providers just like her, from preparing for the pandemic in March to being furloughed in April, and eventually laid off in June. Almost 1.5 million health care workers lost their jobs at some point during the pandemic, leaving many experienced providers unable to treat patients in need.

(07/17/20) Supporting Health Care Delivery in Low-income Areas During COVID-19
A blog post featured in Health Affairs discussing the impact of the COVID-19 pandemic on health care delivery in low-income areas across the country. Low-income communities, whether urban or rural, are less profitable and as such even more vulnerable to losses in revenue, potentially putting access to health care at risk.

(07/14/20) 2020 Review of Physician and Advanced Practitioner Recruiting Incentives and the Impact of COVID-19
A new report from the health workforce research firm Merritt Hawkins evaluates the impact the COVID-19 pandemic has already had on physicians and other practitioners. Included in the report are predictions for physician shortfalls and examinations of the differences in compensation related to the pandemic.

(07/14/20) Coronavirus Pandemic Flips Clinician Workforce Market
An analysis of a new report form Merritt Hawkins, this article discusses many of the key findings regarding how COVID-19 has changed health workforce demand. Among those findings include significantly reduced demand for hiring new physicians and increased demand for nurse practitioners and physician assistants.

(07/14/20) For Pediatric Primary Care Providers, Federal Relief Funds During the Pandemic May Be Inadequate
A blog post covering the programs to help pediatric primary care providers survive the hits to revenue as a result of the COVID-19 pandemic, as well as the difficulties qualifying for and utilizing those funds. Many pediatric primary care providers are already working as safety-net providers with reduced reimbursement, and do not qualify for many of the congressionally passed aid programs.

(07/13/20) Pickup Truck Medicine: Saving Primary Care During COVID-19
An opinion piece about the most effective ways to preserve primary care providers during the COVID-19 pandemic. Recommendations include more regulatory flexibility, improved access and utilization of telehealth technology, protecting workers both physically and mentally, and improving their pay to reflect the service provided.

(07/07/20) The Coronavirus Pandemic Could Change the Way America Pays for Health Care
As the COVID-19 pandemic forced many private physician practices to reevaluate how they treat their patients, including large shifts to telehealth and virtual visits, some are looking to the potential for widespread reform in the way health care is paid for in the United States.

(07/02/20) 358K Healthcare Jobs Added in June; Hospitals See 1st Gain Since March
An article covering the change in employment within the health workforce for the month of June. For the first time since the onset of the COVID-19 pandemic, hospital employment has increased following the sharp decreases in previous months.

(07/01/20) Hospitals Must Treat Infection Control as a Priority, Not a Profit Center
An opinion piece calling for hospitals to prioritize infection control and their infection control workforce as a means of preventing unnecessary spread of COVID-19. Hospital acquired infections lead to thousands of deaths per year, however there is hope that prioritizing preventing COVID infection may lead to long-term improvements in infection prevention in hospitals.

(07/01/20) Hollowed Out Public Health System Faces More Cuts Amid Virus
A joint investigation between the Associated Press and Kaiser Health News uncovers the increasing difficulties many state and local health departments are having in dealing with the COVID-19 pandemic, and looks at the reasons for these struggles. Significant reductions in funding and loss of workforce in the past few decades as well as further budget cuts, layoffs, and furloughs seen during the pandemic are causing even more difficulties for public health in the United States.

(07/01/20) COVID-19 and the Financial Viability of US Rural Hospitals
A blog post authored by researchers who study rural hospitals in the United States covering the unique impact COVID-19 has had on their operations. Rural hospitals represent 30% of hospitals in the United States and most struggled to operate financially even before the pandemic. The loss of revenue from elective procedures has put their operation in risk, and a number of governmental responses have been developed to try to assist them.

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