The "Pathways to Coverage" demonstration was borne out of the Health Adult Opportunity guidance released by CMS earlier this year.
The Centers for Medicare & Medicaid Services (CMS) announced that Georgia's new Medicaid section 1115 demonstration called "Pathways to Coverage" was approved Thursday afternoon.
According to a CMS press release, the Pathways to Coverage creates an opportunity for working-age Georgians who are ineligible for Medicaid to opt into through program through "qualifying activities like work and education, as well as meeting premium and income requirements."
Specifically, the policy applies to adults between the ages of 19 and 64, with income up to 100% of the federal poverty line.
Participating adults must work 80 hours per month or complete other "qualifying activities," and CMS added that most participants will be required to "make initial and ongoing monthly premium payments."
CMS projected that 30,000 Georgians will gain access to Medicaid coverage in the first year, while almost 65,000 will enroll or receive Medicaid premium assistance for coverage through employer-sponsored coverage during the entirety of the program.
"President Trump has long understood that states should have maximum flexibility over their own healthcare programs, because innovative leaders like Governor Kemp know their states and have good ideas worth testing," CMS Administrator Seema Verma said in a statement. "I’m thrilled to support this comprehensive state-led reform that will help thousands of working adults in Georgia gain access to coverage for the first time in a way that addresses both their health and socio-economic needs."
The Pathways to Coverage demonstration was borne out of the Health Adult Opportunity (HAO) initiative released by CMS earlier this year.
The HAO, first announced in January, allows states that have expanded Medicaid under the Affordable Care Act to transition state Medicaid programs into a block grant program.
The guidance marked the culmination of a decades-long goal by Republicans to transition state Medicaid programs into block grants as a way to cap spending and increase flexibility in managing the programs.
Both provider and payer associations criticized the Trump administration's Medicaid block grant announcement, arguing that the initiative would reduce access to care for beneficiaries and alter long-standing prescription drug formularies.
Many healthcare organizations publicly opposed the guidance, including the American Medical Association, the American College of Physicians, the Association of American Medical Colleges, and the Leadership Conference on Civil and Human Rights.
CMS noted that Georgia will be "financially accountable" for a budget neutrality test related to the demonstration.
Additionally, CMS said the agency has completed its review of Georgia's 1332 waiver request and is "working with the state and federal partners to finalize the terms and conditions" for approval.
The Hammond Hanlon Camp LLC research was released just over a week after Kaufman Hall's latest M&A analysis.
M&A activity among hospitals and health systems in 2020 still trails the pace set in 2019, though many executives expect an uptick in 2021, according to a Hammond Hanlon Camp LLC (H2C) analysis released Thursday.
During the quarter, 18 transactions were announced, down from 22 announced deals in Q3 2019. Similarly, managed care deals were down 63% year-over-year.
Year-to-date, there have been 57 hospital deals, down from 66 announced transactions this time last year.
Overall, quarterly healthcare M&A activity was up 9% compared to Q3 2019, though year-to-date deals are down 7% compared to 2019.
The analysis attributes the decline in transactions to a slow Q2, marked by the effects of the ongoing COVID-19 pandemic.
For the full year, Walgreens reported metrics that were similar to the company's quarterly performance: sales rose while operating income, EPS, and adjusted EPS fell.
Walgreens Boots Alliance ended fiscal year (FY) 2020 with mixed financial results, including a small uptick in sales but declines in operating income, earnings per share (EPS), and net cash provided by operating activities, according to the company's earnings report released Thursday morning.
For the quarter, Walgreens saw sales increase 2.3% to $34.7 billion, though operating income and adjusted operating income both fell more than 26%, respectively.
The company's EPS declined nearly 43%, adjusted EPS fell just over 28%, and the "estimated adverse COVID-19" impacted was measured at $0.46.
For the full year, Walgreens reported metrics that were similar to the company's quarterly performance: sales rose while operating income, EPS, and adjusted EPS fell.
Additionally, net cash provided by operating activities dropped by $109 million year-over-year, while free cash flow increase to $4.1 billion.
C-suite perspective:
"I am pleased to report results that came in at the high end of our expectations as we continue to adapt and transform our business model to changing customer needs," Stefano Pessina, CEO of Walgreens, said in a statement. "Despite uncertainty amid the global COVID-19 pandemic, we are seeing gradual improvement in key U.S. and UK markets and continued strong performance in our wholesale business. I'm also encouraged by the accelerating growth in our e-commerce platforms. Now, more than ever, our pharmacy-centered business is at the heart of community healthcare and we are expanding on that role for the future. I continue to be inspired by the tireless efforts of our teams as they support and care for our customers, patients and communities, while accelerating progress on our clear set of strategic priorities. Looking ahead, we are projecting adjusted EPS growth in fiscal 2021, as reflected in our new guidance."
Going forward, the company has projected "low single-digit growth" in adjusted EPS for FY 2021.
Walgreens also anticipates that the negative impact of the pandemic will gradually reduce during FY 2021 but expects the first half to still be affected by the outbreak.
"Significant investments in fiscal 2021 are expected to accelerate the company's customer-centric approach, with specific focus on transforming omnichannel capabilities and offerings across retail and healthcare. These investments are expected to contribute to the second-half growth profile," the company stated in a press release. "While this guidance anticipates a continued gradual reduction in COVID-19 impacts, the evolution of the pandemic remains uncertain. COVID-19 could present both incremental risks as well as opportunities for the company's business."
Since releasing its Q3 earnings report in early July, Walgreens has undergone multiple leadership changes.
On July 27, Pessina announced that he would step down as CEO and assume the role of executive chairman of the company. Meanwhile, on August 31, Walgreens announced that John Standley, former CEO of Rite Aid, would lead U.S. operations as president of the company.
In the face of continued uncertainty, finance leaders are trying to plan for the worst and yet maximize revenue opportunities to salvage what remains of the bottom line.
We are in the final quarter of the calendar year and hospital executives around the country are gearing up for what could be a challenging few months due to the potential combination of the COVID-19 pandemic and flu season.
Provider organizations are taking all of the necessary precautions to protect their patients and employees from infection, but in the face of continued uncertainty, healthcare finance leaders are trying to plan for the worst and yet maximize revenue opportunities to salvage what remains of the bottom line.
In this month's episode of the HealthLeaders Finance Podcast, Kent Lehr, chief of business development at Sanford Health in Sioux Falls, South Dakota, details how the rural health system is preparing for COVID-19 during the upcoming flu season and for the organization's financial health. Lehr started at Sanford Health in August 2020.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders: Kent, I wanted to start off by asking what are your top priorities for Sanford as you take on this new role, especially during a time of crisis? Are there any specific initiatives or projects you're focused on?
Lehr: I think one of the things that has attracted me to this organization for a long time has been their steadfast focus on their strategic direction. One of the things that I'm proud of being part of Sanford now is that we don't panic. While there are definitely unique challenges that 2020 has brought about, and we're expecting 2021 to be much of the same, we're focused on continuing to be a growth company. We're focused on continuing to use our platforms within the organization to expand, grow, and create new and diverse relationships and partnerships that not only can help us through the current COVID crisis, but will have long-term benefits to the patients and the communities that we serve.
Being new to this organization, my goals in this role are just to continue to help Sanford execute on their strategy of being a growth company and ensure that we're a good partner for organizations out there that want to grow and develop new capabilities, solutions, and tools for us and our patients. While COVID challenges are broad and causing a lot of organizations to shrink or to pull back investments, we're very much the opposite. We are trying to figure out how we can use this challenge, and use COVID, as a way to catalyze the growth of our organization so that on the back end of this, we're that much better positioned to take care of the communities and the people that need us the most.
HL: Regarding the COVID-19 pandemic, how should provider organizations approach acute short-term financial issues while also remaining flexible enough to focus on long-term business opportunities?
Lehr: My advice is that you just don't panic. There are always going to be challenges [even] if there wasn't COVID. Go back [through] the last decade and there have been numerous challenges that have impacted the healthcare industry; COVID is just one more example of those things that you can't plan for. I think that the resiliency of the organization is going to be contingent on how you handle challenges and crises.
You immediately look at non-labor efficiencies and so [Sanford's leadership] posed a challenge to the organization: where can we find non-labor efficiencies and cost savings until we have a better understanding of what the impact of COVID is going to be on the organization? The second [strategy] was that we got to use scale to our advantage. Sanford is a large organization that is well integrated in the communities that we're in, but our ability to move supplies and resources, both clinical and nonclinical, across the 26 states that we're in has been a huge benefit. Frankly, this is a benefit that smaller organizations just simply don't have, and so we used scale to our advantage to ensure that our people in our communities were protected.
The third [strategy] was simple: just stay focused. Being a large organization, we've got a wide breadth of skill sets, diversity of backgrounds, and education amongst our workforce; so how do [leaders] tap into the right people with the right skill set to handle the crisis and stay focused on the other things that are important to our business long term? We've proven an ability to do that while learning from the challenges in the present day.
[Finally] the fourth [strategy] is that we've got to invest in our people. I've seen too many headlines where organizations have quickly furloughed, laid off, or cut their workforce. That's the workforce that our communities are relying on to take care of them and to protect them during this time. I'm proud of Sanford's commitment to our team members across the enterprise and the investments in those teams through specific programs meant to help them through this COVID challenge. We're going to deal with other challenges as we go forward, and we want to make sure our workforce is taken care of and does not feel like we left them out as we tried to deal with the challenges at the organizational level.
HL: As we head into the fall and potentially face a combination of a second wave of coronavirus cases along with the beginning of flu season, what is Sanford doing to prepare for these dual challenges?
Lehr: First, let's ensure and encourage everyone in our communities to get their flu shots and try to mitigate the risk with flu season. We are requiring all of our 50,000 employees to get their flu shots before November 1.
Then you start to go up levels; we look at what things we can learn from when COVID cases began to spike in the spring. There wasn't a lot of information, science, or research at the time—we were learning every day. However, some of the things that we've developed in terms of our staffing plans, our ability to flex facilities in our capacity plans, those are things that shouldn't just collect dust. We're continuing to refine how we performed during that first phase and ensuring that if there is a spike in COVID cases in any of our regions that we're able to learn from how we responded to that first time and make improvements from an operational standpoint.
I think that there's a misconception that if you're in a large scale healthcare organization that you somehow sacrifice local healthcare delivery, and I think that's wrong frankly. This pandemic is a great example of where scale helped enhance our ability to provide excellent local healthcare, and our organization is going to continue to do that.
HL: From your prior experience leading the UnityPoint Ventures investment fund, what advice would you give to hospital and health system executives that might be looking to increase their organization's investment in healthcare innovation? What lessons or warnings would you give them about this new pursuit?
Lehr: First, you've got to be motivated, especially with the ventures work, by more than your financial returns. The ethos at Sanford has been about research and innovation since I've known the organization. And so, at a minimum, you've just got to want to innovate, and you've got to want to be disruptive, even if that disruption is to yourself. As long as that's a core part of your culture and ethos, it's just going to work better in your organization.
As we started the venture work, the success wasn't going to be measured simply by the financial returns. We weren't private equity, venture capital, or angel investing, our goal wasn't venture returns solely. Our goal was around what was going to be the clinical benefit, what was going to be the operational benefit, and what was going to be the benefit of patient experience. As a healthcare organization, that's the critical piece; it's understanding how you measure success. If it's simply just financial returns, there are others out there much better at that, and that was one of the key learnings for us.
I think what's so attractive about Sanford is that if you look at the investment in our research organization, I'd be hard-pressed to find another community health system in the world that has the amount of investment, infrastructure, and research that Sanford has.
There's an underlying culture of curiosity; it's a learning organization, and that's foundational if you want to expand into ventures or create a fund or an incubator. Having that platform is going to be beneficial for any organization. If you're nervous about disruption, then I would say it's probably not for you. But if you're an organization that's steadfast and crystal clear on what success looks like, and you're looking at it more broadly than purely financial returns, then it allows you to partner with the right people from the financial sense: the ecosystem of entrepreneurs that are out there, the startup companies—you bring them all together, you provide a platform, and you've got the culture, and I think you can be successful.
The survey results were released less than a month before Election Day.
Nearly 80% of adults said that healthcare policy will influence their votes in the upcoming election, according to a Sapphire Digital survey released Wednesday morning.
Half of those respondents indicated that healthcare policy will "most influence or heavily influence their votes compared to other policy issues."
One-third of adults said they want both President Donald Trump and former Vice President Joe Biden to prioritize lowering healthcare costs as part of their respective policy goals.
The survey results were released less than a month before Election Day.
“There have been many moving pieces in health care this year, including COVID-19 which has pushed health care policy and price transparency to the forefront of Americans’ minds,” said Kyle Raffaniello, Chief Executive Officer of Sapphire Digital. “As the industry moves to increase price transparency, we must educate consumers about the easy-to-use tools available through their health plans to shop for and select health care that meets their needs both from a cost and quality perspective.”
Almost half of the respondents said the COVID-19 pandemic made healthcare price transparency "more important to them than before.
Nearly 70% said they would research costs of procedures before going in for treatment if "there was an easy way to view the total medical cost for the procedure or their personal out-of-pocket costs."
Still, one-third of respondents said the healthcare system is "too complex and not easy to navigate."
Going forward, over half of respondents indicated that they will make changes to how they select care and one-third said that more information on their "total health financial position and a clear explanation of their benefits" would make it easier to save.
The Minnetonka, Minnesota–based insurer's latest financials mark the beginning of Q3 earnings season for healthcare companies.
In the face of continued headwinds stemming from the COVID-19 pandemic, UnitedHealth Group reported over $65 billion in quarterly revenues, according to its latest earnings report released Wednesday morning.
By segment, the insurer benefited from the sustained performance from both Optum and UnitedHealthcare.
Optum's earnings from operations and revenues for Q3 both rose, with revenues nearly hitting $35 billion. Though earnings from operations slid, UnitedHealthcare's quarterly revenues were up $2.3 billion year-over-year.
UnitedHealth did experience a decline in earnings from operations, down $300 million year-over-year, which the company attributed to consumer financial assistance measures taken and broader costs associated with COVID-19 testing.
Additionally, the insurer's net earnings per share (EPS) and adjusted net EPS were both down 10% year-over-year.
Forward-looking, the company updated its year-end EPS to a range of $15.65 to $15.90 per share, with adjusted net EPS of $16.50 to $16.75 per share.
The Minnetonka, Minnesota–based insurer's latest financials mark the beginning of Q3 earnings season for healthcare companies.
C-suite perspective:
"The people of UnitedHealth Group continue to deliver more innovative and modern solutions for customers, physicians and consumers, while responding to the needs of the people and communities affected by the pandemic," David S. Wichmann, CEO of UnitedHealth, said in a statement. "We’re encouraged to see those we serve respond to the incentives we offered
to safely seek care as the health system continued to recover in the quarter."
UnitedHealth's earnings were released just over two weeks after the company acquired DivvyDose, a privately-held pharmacy startup, and a competitor to PillPack, a subsidiary of Amazon.
Reyngoudt joined Tower Health in 2018 as CFO of Brandywine Hospital.
Reading Hospital – Tower Health announced the appointment of Mark Reyngoudt, MBA, as CFO Friday morning.
Reyngoudt joined Tower Health in 2018 as CFO of Brandywine Hospital. He has more than 20 years of experience as a healthcare CFO, notably serving at UPMC Pinnacle Carlisle.
Reyngoudt is a graduate of both the University of Texas - Tyler and Ambassador University. He serves on the board of directors for the Western Chester County Chamber of Commerce.
The Nashville-based for-profit hospital operator also anticipates revenues of $13.3 billion in Q3.
HCA Healthcare announced Thursday afternoon that it will return, or repay early, $6 billion in government funding provided as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act and Medicare accelerated payments.
According to a filing with the Securities and Exchange Commission (SEC), HCA said it plans to repay $4.4 billion received in Medicare accelerated payments and $1.6 billion received through the Provider Relief Fund distributions authorized by the CARES Act.
C-suite perspective:
"We greatly appreciate the CARES Act funding and the policymakers who fought hard to ensure hospitals would have the essential resources during the pandemic," Sam Hazen, CEO of HCA Healthcare, said in a statement. "As the initial immediacy of the emergency has passed, and with more information, and more experience managing our operations during the pandemic, we believe returning these taxpayer dollars is appropriate and the socially responsible thing to do."
HCA, like many for-profit hospital organizations, suffered significant financial impacts related to the COVID-19 pandemic but was also able to mitigate the damage thanks to the stimulus packages passed by the federal government this spring.
According to the company's most recent earnings report, same facility admissions fell almost 13% during Q2, while same facility equivalent admissions declined just over 20%.
HCA's revenues fell more than $1.5 billion year-over-year and the company recorded losses on sales of facilities of $27 million, compared to gains of $18 million in Q2 2019.
In addition to announcing the planned return of government funding, the Nashville-based for-profit hospital operator also said it anticipates revenues of $13.3 billion in Q3.
HCA stated that it expects income before taxes to total approximately $950 million and adjusted EBITDA to top $2 billion.
However, the company said it expects same facility admissions to decline by 4% during the quarter, same facility equivalent admissions to decline 9%, and same facility emergency room visits to decline 20%.
HCA indicated that it expects to report its Q3 2020 earnings on, or about, October 26.
The RWJBarnabas Health CFO discusses financing the organization's SDOH initiatives and how the system is preparing for an uncertain future marked by the pandemic.
Over the past several months, HealthLeaders has spoken with several members of the C-suite at RWJ Barnabas Health, the 11-hospital system based in West Orange, New Jersey.
These conversations have focused on efforts to affect the social determinants of health (SDOH), the effects of the ongoing COVID-19 pandemic on the organization, and the financial standing of the system.
According to its most recently available financials, RWJBarnabas reported a total operating revenue of $2.8 million for the first six months of 2020 ended on June 30.
John William Doll, CPA, CFO of RWJBarnabas, spoke with HealthLeaders about financing the organization's SDOH initiatives, and how the system is preparing for an uncertain future marked by the pandemic.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders: Can you walk me through how you're working to finance the various SDOH and community health projects for RWJBarnabas?
John William Doll: SDOH is something that's become ingrained in our culture and existed pre-pandemic. We formally launched a social impact and community investment practice three years ago because we see supporting the community as core to our mission. In terms of financing the efforts, we've handled it in a bunch of different ways.
First and foremost, in connection with launching the social impact practice, we've dedicated a portion of our unrestricted cash investment balance to fund initiatives that are tied to the social impact practice and a major piece of that is addressing SDOH. We earmarked $30 million in spending to address housing and food insecurity. In addition, as part of our normal budgeting process, we’ve allocated resources that promote health and wellness, and we funded them through our operations.
Where we can, we also leverage existing networks. We don't think that recreating everything is the right answer. There are several organizations that do this work in the communities and they do a phenomenal job. One thing we've done is invest in technology that connects our people and patients to those services when we identify the need. Another thing we've done is we've partnered with Horizon Blue Cross on a community health worker project, and that's built off of models that have been successful in other parts of the country, including a successful pilot in Newark.
Ultimately, as we move to value-based contracting, there are rewards and payments for reducing overall healthcare spend. We know that one reason that healthcare spend is higher than it should be is because of SDOH. As we're successful in helping to address those issues, it creates gainsharing. Horizon is focused on that because of the business they're in, and we're focused on it because we want to make our communities healthy, and we're jointly funding the expansion of that program.
HL: How has RWJBarnabas balanced its long-term financial strategy with the acute, short-term issues it faces?
Doll: That tension always exists, and perhaps, has been heightened because of the uncertainty. What it comes down to is that there's probably never enough capital in an organization like ours to do everything that we need.
The balance is prioritizing where you want to spend. What we've done is continuing with planning and evaluation for some projects, but not committing fully to them unless we're sure they're aligned with that long-term strategy, and move some up on the list that are supplemented with planning that we learned from COVID.
A great example is that we had an ER renovation and construction project at one of our facilities that we paused and reevaluated from what we learned [during] COVID. We've redesigned the plan such that it'll create a better [physical] separation should we ever need to get back to isolation of COVID-positive patients from other [patients and staff].
We've created more isolation capacity than was [originally] in the plan, and then restarted it because we know that that's something that will be needed. If there is a second wave that is anything like what we saw the first time, we will be better situated from a physical plan perspective.
HL: A lot of the CFOs I've spoken to have said that they've moved to more dynamic budgeting and financial forecasting on kind of a rolling basis; I'm curious if that's something that you and your financial team have embraced at your organization. What is your outlook for the rest of the year and going into 2021? How are you preparing for what could be a second surge?
Doll: If you ask someone in my position and they give you an answer other than, 'The historical budgeting process is insufficient in the environment we're in,' then they probably should be in another role. We've had such dramatic events impacting all of our business and you need to be more agile in addressing that in order to meet the needs of the people in our communities.
We haven't pivoted to a full rolling forecast, we've done some of that in the past, because a lot of our efforts are still focused on preparing our facilities. What did we learn from the pandemic? How do we best learn from shortages in equipment and supplies to make sure that we're not scrambling? Thankfully, we never ran out of PPE for our staff, but there was a lot of effort put in place to do that and we certainly paid premium. We're looking at rebuilding stockpile systems to deploy that equipment more flexibly than what we had in place.
Related: Mid-year Analysis: Almost 60% of New Jersey Hospitals in the Red
Our strategy going into the pandemic was to focus on regional centers of excellence, consolidation of services, and matching the market's need in terms of moving away from strictly acute care and ambulatory settings. If anything, the pandemic validated that strategy, so we're accelerating that. We're fortunate that, from at least the balance sheet perspective, we were in a position of strength going into the pandemic, so that's created a little bit of luxury as we deal with that.
It's just impossible to predict what next year will look like based on the change that's occurred. What I can tell you is we did recast our budget in June, with a prediction through the end of the year, based on what we thought the recovery rate was going to be. That creates a cash flow profile and gave us a sense of where we'd end the year and for capital plans, do everything we need to do from a finance perspective. We're measuring against that, as opposed to historical budgets, and we do adjust that every month. Thankfully, the pace of returns [are] more rapid than what we had originally anticipated.
HL: We've seen the rise of telehealth throughout the crisis, but what are your thoughts on the financial sustainability of the program in a post-pandemic landscape? Additionally, are there any other financial innovations that you expect hospitals and health systems to keep around after we get a vaccine?
Doll: Our experience was remarkable. One thing that maybe isn't 100% evident is that the resistance to adoption of telehealth was [primarily in] a certain group of patients and providers. We did have some of our doctors during the initial [telehealth] rollout pre-pandemic that felt like they would lose a connection with their patient if it wasn't in a live visit. Being forced into that, because of the pandemic, has changed their mindset and outlook.
I think people's perception, both from a consumer-patient perspective and a provider perspective, has been changed, and that will fuel some of the ongoing stickiness of telehealth. Our telehealth program before the pandemic was limited to episodic urgent care. If [a patient] was sick in the middle of night, they could jump on our app and see an ED doctor, or perhaps get flu medicine or a prescription refill. It wasn't really for anything other than that, particularly not for sustained screening processes.
We went from 0 to 10,000 visits-per-week in our employee medical group within the first two weeks of the pandemic. That's now dropped down to about 4,000 visits-per-week, as in-person care has increased. At the peak, [telehealth] was probably 90% of the volume we were seeing, because a lot of offices were closed, and now it's down to about 30%. The sustainability, to a large degree, will be dependent upon the payers and government continuing to support it. CMS has greatly relaxed the regulations around telehealth because of the pandemic and they've announced expansion and criteria around continuing those regulations.
I believe that if those are sustained, the model will make sense and creates more scalability for physicians. It creates, in some instances, better access to specialists. Ultimately, there do need to be in-person visits at a certain level. But in theory, as you're screening and doing other things, you could see more patients, create better access, and that needs to be balanced with a true population health model that doesn't create a churn utilization because it's easier for patients. I know that's what the insurance companies are worried about in my discussions with executives at those organizations.
Much like during the first presidential debate, Pence and Harris argued over the fate of the ACA, the administration's response to the pandemic, and other healthcare-related policies.
Vice President Mike Pence and Sen. Kamala Harris squared off over several healthcare topics at the first and only scheduled vice presidential debate Wednesday night.
The debate took place at the University of Utah in Salt Lake City and was held two days after President Donald Trump was discharged from Walter Reed Medical Center after testing positive for COVID-19 and spending three nights at the facility.
Related: President Trump Discharged From Walter Reed Medical Center After 3-Night Stay for COVID-19
Much like during the first presidential debate, Pence and Harris argued over the fate of the Affordable Care Act (ACA), the administration's response to the pandemic, and other healthcare-related policies.
Below are some key healthcare takeaways from the vice presidential debate.
National response to COVID-19
Harris reiterated former Vice President Joe Biden's criticisms of the Trump administration's response to the COVID-19 pandemic, which has killed over 210,000 Americans.
She called the Trump administration's response to the pandemic the "greatest failure of any presidential administration in the history of our country."
Additionally, Harris criticized the administration's lackadaisical response to the virus and said Trump still lacks an effective plan to address the pandemic.
Pence, who heads the administration's COVID-19 task force, countered that Biden's proposed response to the virus mirrors that of the administration's ongoing efforts.
Pence echoed Trump's timeline for a potential coronavirus vaccine, mentioning during the debate that "tens of millions of doses" will be available by the end of the year through Operation Warp Speed.
When asked, Harris said she would be "first in line" for an approved coronavirus vaccine if public health officials endorsed the vaccine but said she would not if Trump was the one touting the vaccine.
Pence criticized Harris for remarks that indicated skepticism about the efficacy of a potential coronavirus vaccine, asking her to "stop playing politics with people's lives."
He added that Harris shouldn't "undermine public confidence" in a potential vaccine.
ACA up in the air: 'They're coming for you'
The debate highlighted the continuing differences between the Trump administration and the Biden campaign over the future of ACA.
Harris said COVID-19 might be considered a pre-existing condition in the future, while adding that Biden wants to expand coverage, introduce a public option, and lower the age of Medicare eligibility.
On the other hand, Pence said that the ACA was a "disaster that the American people remember well."
Pence was asked about how the administration would uphold its promise to cover those with pre-existing conditions should the ACA be overturned but did not detail what a potential plan would look like.