How Will the Biden Healthcare Agenda Impact Health Systems?

Hospitals and health systems are interested in how President-elect Biden will handle the ongoing coronavirus crisis, healthcare policy reform, and several regulatory items.

While hospitals and health systems continue to deal with the surge of patients infected with COVID-19, a question has emerged about what President-elect Joe Biden's healthcare agenda will mean for provider organizations.

Biden has yet to name his nominee for Secretary of the Department of Health and Human Services (HHS) but the focus has already shifted to what the incoming administration will try to pursue as it relates to healthcare reform and COVID-19 public health policy.

To that end, the Federation of American Hospitals (FAH) issued a public letter to Biden on Sunday outlining the organization's priorities for his transition team.

According to FAH, the primary focus of the incoming administration should be addressing the ongoing COVID-19 pandemic and surge in cases going into the winter.

"It is mission critical that the pandemic be brought under control," the letter read. "Therefore, at the outset, we urge immediate action to extend the PHE, which was last renewed for 90 days by the Secretary of the Department of Health and Human Services (HHS) on October 23, 2020. This renewal is paramount for hospitals to sustain efforts to meet COVID-19 as it surges into 2021."

Two healthcare stakeholders spoke with HealthLeaders recently about how the incoming Biden administration's healthcare agenda will affect hospitals and what executives should focus on in the coming months.

Related: What Biden Can Do to Combat COVID Right Now

Ben Isgur, the leader of the Health Research Institute at PricewaterhouseCoopers (PwC), said there are three major areas that the Biden administration is going to focus on as it relates to providers: pandemic response and vaccine distribution, expanding health coverage, and care delivery changes.

As Biden is likely to face a divided Congress, Isgur said that the administration's reform goals will likely center on shoring up the Affordable Care Act (ACA), potentially through the introduction of a public option, but also through improved marketing and communications efforts surrounding enrollment in the program. 

"The other side, in terms of getting more coverage, is on Medicaid; a dozen states have not expanded Medicaid and I think the big question is could a Biden administration make some inroads with those governors and if there's a more [significant] economic downturn, do the numbers [change] in terms of expanding Medicaid?" Isgur said. "I think it's going to take a lot of allies helping out with that, primarily from the business community. In some of these states that haven't expanded Medicaid, if you were to see the general business community and chambers of commerce step up and say, 'Hey, let's bring this money into the states and get these people covered' and make an economic case for it, I think you could see some movement there."

Related: AMA Offers Conditional Support for Public Option Health Plan

Isgur added that while Democrats have a chance to take control of the Senate, depending on how two runoff races in Georgia turn out in January, there would still be a slim margin of control that would likely dissuade any effort to pass a major healthcare reform package.

There are some areas of common ground on the regulatory front, Isgur said, including price transparency, prescription drug pricing, surprise billing, and value-based care. Still, there's likely distance between the ongoing Trump administration and the Biden team as it relates to approaching healthcare M&A activity. 

"Maybe one difference could be on [healthcare] deals and consolidation, there might be some different views towards how much scrutiny there would be under a Biden administration on deals that would result in more market consolidation," Isgur said. 

Related: Biden Presidency, Divided Congress 'Credit-Neutral' for Healthcare Sector

Kristi Ebong is the senior vice president of corporate strategy for Orbita, a HIPAA-compliant conversational AI platform based in Boston.

Ebong said provider organizations have struggled in recent months to both handle the influx of patients infected with COVID-19 while also focus on long-term investments for a post-pandemic landscape, such as with technology that improves the patient experience.

She told HealthLeaders that actions taken by the Trump administration during the pandemic to lift restrictions on telehealth services have encouraged hospitals to embrace virtual care and leaders will likely look to how the Biden administration will approach the issue come January.

Ebong added that a critical issue she's paying attention to is the need among hospitals to diversify reimbursement for virtual care revenue streams and whether the Biden administration will be willing to expand those opportunities for providers.

"We've seen this reckoning within healthcare and health technology where a huge chunk of people who may have never adopted [virtual care] before have used it, so we have a more educated consumer and business stakeholder, whether they had digital literacy in health technology or not," Ebong said. "[Providers] are saying, 'We can provide care in a much more cost-effective way, let's standardize those pathways so we can continue to do that.'"