Hazard Pay for Health Care Providers During COVID-19

Written by Ben Ulrich, Mallorie Holguin and Alex Wine

Published by AHLA

The escalating spread of the coronavirus (COVID-19) has gripped the world in a pandemic. As of April 13, over 1,870,000 cases and more than 116,000 deaths have been reported worldwide due to COVID-19, with over 558,000 cases and 22,000 deaths in the United States alone.[i] Cases across the nation have been increasing daily at exponential rates and health care systems are being overwhelmed with the mounting strain of curtailing the disease. As an emergency measure, the federal government has acted under section 1135 of the Social Security Act, waiving various regulatory requirements to assist with combating the outbreak. Some of these waivers include prior hospitalization requirements for coverage of a skilled nursing facility, limitations on the number of beds and length of stay at critical access hospitals, housing of acute care patients in distinct units, out-of-state provider licensing requirements, and provider enrollment requirements, among various others.[ii] As the demand for COVID-19 screening, testing, and intensive care grows, health care providers have become critically needed and, as such, face significant health risks of their own.

Securing Coverage During a Pandemic


Health care providers staffing the nation’s emergency departments, clinics, and hospitals are being exposed to potentially infected patients daily. This risk is exacerbated by a shortage of personal protective equipment (masks, gowns, etc.),[iii] which increases the likelihood that health care providers may contract the virus. Not unlike employees/contractors in other industries, being asked to take on these risks may necessitate premium compensation in certain circumstances. Whether that premium is warranted and to what degree heavily depends on the potential health and financial risks incurred by the provider and the financial sustainability of the hospital during this pandemic. Specifically, health systems and hospitals should consider the following when determining pay rates to providers being asked to care for COVID-19 patients:

  • Viable Options for Staffing: Given the drastic financial and operational impact health systems are undertaking during the pandemic, all existing or potential staffing options should be evaluated prior to considering pay premiums. Redeploying providers outside of their normal role (e.g. certified registered nurse anesthetists being redeployed from elective surgeries to provide ICU back-up) or leveraging telemedicine to triage patients may be viable options, among others.
  • Health Risk: The degree to which a provider is likely to contract the virus and the subsequent severity of the illness.
  • Surge / Out-of-Market Staffing: Whether the event requires higher levels of staffing than normal, increasing the market demand for providers and/or requiring providers to travel from out-of-market on a temporary basis to meet patient demand.

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