2023 Trends, Events, and Developments (TEDs) in the Payer World: The End of the Public Health Emergency

Good day to you! I am Cynthia Miller, MD, MPH, FACP, Vice President Medical Director – Access Experience Team, and editor of All Access Newsletter. This edition will focus on:

Care Delivery Changes and Challenges after the Public Health Emergency
Christy Banach—Senior Director, Access Experience Team
Christy discusses the recall of several provisions of the Public Health Emergency and the impact on hospital facilities, addiction care, and insurance coverage. She addresses what pharmaceutical companies can do to mitigate the loss of access to medications and insurance.

Post-PHE Medicaid Disenrollment and the Impact on Employer Groups
Jorge Font, MPH—Senior Advisor, Access Experience Team
Jorge delves into the issue of Medicaid Disenrollment and its impact on the commercial market.  He discusses which industries will be impacted by the disenrollment as well as expected cost-shift implications.

Shortages All Around: The Implications of Staff Shortages and Rural Hospital Closures on Access to Care
Cynthia Miller, MD, MPH, FACP—Vice President, Medical Director – Access Experience Team
Cynthia addresses how staffing shortages and strains on rural hospitals will be exacerbated post-PHE. She suggests several solutions that pharmaceutical companies can support to preserve access to care.

Beyond the PHE: Forging a More Resilient Future
Maureen Hennessey, PhD, CPCC, CPHQ—Senior Vice President, Director, Value Transformation
Maureen wraps up our issue with the lessons learned from the pandemic. She discusses how life science companies can join other stakeholders to reduce the risk for future pandemics and to improve health inequities post-PHE.

We believe you will find these post-PHE and their impact on market access insightful as you navigate the payer landscape. As always, please feel free to drop me a note and let me know if you have a topic suggestion for the payer team to address, and we’ll do our best to cover it in a future edition.

Best Regards,

Cynthia Miller
MD, MPH, FACP
VP, Medical Director
Access
Experience Team

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All Access is a bimonthly newsletter featuring key insights from our team of former payers intended specifically for market access leaders. It is published by PRECISIONvalue.

Guest Editor
Cynthia Miller

Contributors
Amy Martin
Andrew Cournoyer
Ryan Cox
Dan Danielson
Todd Edgar
Jorge Font
Dominic Galante
Ami Gopalan
Maureen Hennessey
Joe Honcz
Erin Lopata
Ray Roth
Janet Serluco
Charline Shan
Jennifer Williams

Care Delivery Changes and Challenges after the Public Health Emergency

As we move into this post-pandemic phase, it is important to consider how the end of the PHE will impact care delivery and patient care now that certain provisions that allowed for expanded, easier access to care may or may not remain in place. Many hospitals, providers, and caregivers continue to deal with the challenges of workforce shortages and financial pressures, cost increases for medications and equipment, supply chain issues, and sicker patients. 

Shortages All Around: The Implications of Staff Shortages and Rural Hospital Closures on Access to Care

Staffing shortages are not new. For years, the industry has been predicting a shortage of physicians and nurses, particularly in rural areas, and there have been calls to expand scope of practice for nurse practitioners, physician assistants, and pharmacists as a result. Enter COVID-19, and staffing shortages accelerated. Physicians, nurses, and other care providers began exiting the job market because of insufficient resources and burnout.

Beyond the PHE: Forging a More Resilient Future

Three years into the pandemic, a recent Lancet editorial observed, “The acute months of the COVID-19 pandemic motivated an unprecedented response from governments, international organisations, pharmaceutical companies, and civil society.” As we transition to a different phase of this pandemic, the need for multistakeholder collaboration continues, to build resilience and prevent or mitigate future pandemics.