DURHAM, N.C. -- Re-opening the United States and containing future COVID-19 outbreaks will require ramping up testing and improving data sharing.
Two steps can be taken now to greatly aid those efforts and improve coordination between public and private health care entities, according to newly released papers from the Duke-Margolis Center for Health Policy.
First, changes should be quickly instituted in how health care providers are paid for COVID-19 testing and tracing. Second, immediate steps can and should be taken to improve the timely sharing of data collected from patients and the public.
The first report outlines payment modifications that the Centers for Medicare & Medicaid Services (CMS) and other payers can adopt now to support the nation’s emerging COVID-19 test and trace program. The proposals build on the agency’s April 30 announcements about additional payments for COVID-19 testing.
While many health care providers and organizations are already building regional test and trace capabilities, these collaborations are uneven nationally and are impeded by the severe financial difficulty facing many health care organizations.
“The nation’s public health system cannot do this alone,” said lead author Dr. Mark McClellan, director of Duke-Margolis and former CMS administrator. “If we are to successfully ramp up testing to the levels required and to rapidly test and diagnose infected individuals, we must further engage physicians’ offices, community health centers, pharmacies and other community health settings as well as special collection facilities and certain businesses.”
The report describes payment reforms that would help health care providers achieve more rapid case detection, management and containment of the COVID-19 pandemic. These payments should encourage use of timely testing in all appropriate individuals, better tests and timely sharing of results, the authors state.
A companion report from Duke-Margolis describes specific short-term steps that can be taken in the next 30-90 days to enable much more rapid and routine data sharing to support COVID-19 containment. The recommendations rely on existing data systems, rather than calling for the creation of new ones.
The report details three immediate, feasible steps to improve collaboration in the fight against COVID-19. The steps would enable public health programs to work more effectively with private partners, including health care providers, clinical laboratories, and other critical partners in COVID-19 containment efforts. They include:
- improving commercial lab reporting of demographic data of people tested for COVID;
- using available clinical data as a supplement to COVID-case investigations; and
- enhancing the use of the National Syndromic Surveillance Program and achieving greater transparency in federal and state use of the data for decision-making.
“The success of COVID-19 containment as the United States reopens will depend on timely sharing of key information related to testing, contact tracing, and detecting and acting on new outbreaks,” said lead author Dr. Farzad Mostashari, CEO of Aledade and former national coordinator for health information technology at the U.S. Department of Health and Human Services.
“But public health, health care, and testing organizations have never had to work together with the scale or urgency required for COVID-19 containment.”