S tatistics reveal that Pharmaceutical companies need to identify unique patient engagement strategies, as failing to do so could lead to a negative impact on reputation. With the rising number of COVID-19 cases in the U.S, there is increased pressure on the healthcare ecosystem, especially from the health insurance perspective. Modernization and healthcare innovation is amongst the key factors that determine access to hyper-personalized and high-quality healthcare. The recently implemented $2 trillion legislation includes over a $100 Billion allocated for emergency funds to neutralize medical service costs incurred by the healthcare providers. The healthcare systems’ ability to respond to the COVID-19 scenario depends on multiple factors. The global medicine supply chain is also causing severe disruptions – with a broad variance in testing capacity across global markets.

To flatten the curve, healthcare leaders are developing data analytics and AI-powered solutions, setting the stage for the future of technologies. The $2T Stimulus package covers a broad range of healthcare services during COVID-19. About $16 billion to provision the country’s stockpile of medical equipment, including ventilators, Personal Protective Equipment or PPE. Over 3,000 hospitals offering healthcare services to uninsured patients can avail an $8 billion insurance through the stimulus package, which will reflect in their Medicaid payments in 2020 and 2021.

The Federation of American hospitals estimates that healthcare systems will receive about $3 billion more due to the suspension of a considerable cut in Medicare fees (2%). This cash infusion will exponentially benefit doctors, nursing homes and home health companies among others. The allocated funds include $117 billion for hospitals and veterans’ health care and $16 billion for a stockpile of pharmaceutical and medical supplies. With significant measures taken worldwide, here’s how to reduce the impact in the short and long term:

• Measures to mitigate potential financial losses. Primary measures could include a cap to financial losses incurred during COVID-19 or to completely waive off money that providers owe the insurance in correspondence to the value-based contracts. Reducing administrative burdens of providers would also add tremendous value, like – quick and prompt approval of prior authorization cases and claims, timeline extensions for claim submissions.


• Bridging the gaps in care – disparate IT systems and clinician burnout are some of the major issues cropping up amidst the outbreak, and healthcare stakeholders need to rethink strategies to create a long-term solution. Healthcare plans, Center for Medicare and Medicaid Services (CMS) and other private payers need to focus their efforts on value-based contracting.


• Leverage data analytics and Insights for customized care. CMS and private payers have announced upfront reimbursements through Accelerated and advance payment program. While financial support may offer a sigh of relief, especially for Physicians and small practices, a one-size-fits-all approach may blur the lines in identifying the ideal provider that needs utmost support. Data-driven approach and profiling such as – patient mix, risk exposure, IT capabilities enable payers to offer customized support, while transforming payer-provider experience and trust.

In essence, assist providers with risk management, a key value add for provider organizations — helping them manage risks and unexpected losses during COVID-19. Consider re-insurance and risk management solutions to providers, specifically individual physicians and small practices. While developing value-based care models, harness the stop-loss clause to enhance provider experiences and loyalty.

Below stats shows the increasing scope of Healthcare and pharma after COVID-19

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