RESUMO
Coronavirus disease 2019 (COVID-19) has led to a surge of patients requiring post-acute care. In order to support federal, state and corporate planning, we offer a four-stage regionally oriented approach to achieving optimal systemwide resource allocation across a region's post-acute service settings and providers over time. In the first stage, the post-acute care system must, to the extent possible, help relieve acute hospitals of non-COVID-19 patients to create as much inpatient capacity as possible over the surge period. In the second stage after the initial surge as subsided, post-acute providers must protect vulnerable populations from COVID-19, prepare treat-in-place protocols for non-COVID-19 admissions, and create and formalize COVID-19 specific settings. In the third stage after a vaccine has been developed or an effective prophylactic option is available, post-acute care providers must assist with distribution and administration of vaccinations and prophylaxis, develop strategies to deliver non-COVID-19 related medical care, and begin to transition to the post-COVID-19 landscape. In the final stage, we must create health advisory bodies to review post-acute sector's response, identify opportunities to improve performance going forward, and develop a pandemic response plan for post-acute care providers. J Am Geriatr Soc 68:1150-1154, 2020.
Assuntos
Betacoronavirus , Defesa Civil/métodos , Infecções por Coronavirus , Alocação de Recursos para a Atenção à Saúde , Pandemias , Pneumonia Viral , Cuidados Semi-Intensivos/métodos , COVID-19 , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologiaRESUMO
The current environment shaping rheumatology practice economics, with a focus on revenues, is described. The policies and practices of private and public insurance companies, pharmaceutical manufacturers, and pharmacy benefit managers (PBMs) are summarized, identifying economic implications for rheumatologists. The role of rebates in shaping practice economics is discussed, along with the central role of payers in defining PBM policies.