Hospitals, physician practices, and other provider organizations are dealing with unprecedented challenges in the present public health emergency following the spread of the novel coronavirus (COVID-19). Providers can expect to continue feeling the impact of the COVID-19 pandemic long after the public health crisis abates. Given that payers control a significant portion of providers' revenue, the financial pressure on providers and successful navigation of the post-pandemic environment will require providers to reset their relationship with payers.
In the pre-pandemic world, providers operated in a landscape characterized by steady and growing patient volumes, broad health insurance coverage, and generally adequate reimbursement. This landscape allowed providers to implement value-based payment models with insurers and other payers. COVID-19 has fundamentally disrupted this landscape. Providers must now look to adapt their payer relationships accordingly.
This publication jointly authored by the lawyers of Jones Day and by BDO outlines some of the current trends providers are facing with respect to their payer relationships, and offers insight on strategies for providers when working with payers in navigating their post-COVID-19 relationships.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
