United against a common enemy, healthcare stakeholders reached across industry lines to solve disruptions to patient care. They rolled out new approaches and revived tools that had difficulty gaining traction under “normal” circumstances. They rewrote many of healthcare’s “old rules.” And they did it all at a pace we’ve never seen before. The trick will be finding a new purpose for the industry to rally around once COVID-19 is long behind us, one that will hopefully begin to mend our nation’s broken healthcare system.
We’ve seen care disruption workarounds like early medication refills and curbside vaccines. Drug manufacturers have helped patients manage unemployment’s financial burden with expanded support programs that offer patients access to free medications. At the same time, private and public payers have stepped up with relaxed regulations and reimbursement agreements. Some insurers have extended a grace period to consumers who can’t pay their insurance premiums, and others have provided direct financial relief to members.
Here’s the thing: There will be no turning back on certain conveniences, like prescription drug delivery and in-home infusions, that bring care directly to patients. The expectations and behaviors that patients are developing will carry over to post-COVID-19 healthcare, and therein lies the opportunity for physicians, payers, life sciences companies, provider organizations and the government to join forces.
Let’s take a closer look at how the patient experience has already shifted. Stay-at-home orders and social distancing mandates have kept patients out of healthcare settings. But the fear of exposure is even more paralyzing, particularly for our most at-risk patient populations. In fact, 60% of the patients we surveyed in April were concerned that they’d contract COVID-19 by receiving in-person care. Even as healthcare continues to reopen, patients are struggling to make the right choice when it comes to preventive and routine in-person care: Stay home and risk overlooking an important signal of illness, or venture out and become infected with the virus? For several months, patients had little choice as most hospitals and private practices postponed non-essential patient appointments and procedures. This, of course, sent demand for telehealth soaring.
Just how widespread telehealth becomes in the post-COVID-19 days will depend on how well we can work through, or around, some of its drawbacks. It’s not surprising that most patients prefer virtual healthcare visits: On top of lower exposure risk, patients benefit from dedicating fewer resources to travel and transportation, childcare and time out of work. And physicians are on board, too, so long as the reimbursement scenario remains viable. From a purely technological standpoint, the health systems with the right tools in place will be able to ramp up their telehealth services more quickly post-crisis than others. And then there are the financial investment and EHR compatibility obstacles, both of which could dissuade private practices and small provider organizations.
In a post-crisis world, payers and providers will have more control over care delivery—and patient outcomes. Health system administrators will have more influence over healthcare decisions like determining where patients receive care, how long they stay in the hospital, and what products are included in the drug formulary or available for procedures. But there’s a good chance that administrators will be making those calls from fewer healthcare locations: Hospital revenues largely have plummeted due to postponed elective procedures, leaving them ripe for takeovers.
CMS has done its part by loosening restrictions during the crisis, namely raising reimbursement rates for telehealth visits and fully covering COVID-19 testing costs. Removing these barriers has put more control in the hands of payers and providers, albeit temporarily. The question is: Will the walls that have come down be rebuilt once the crisis ends? Either way, there’s an opportunity to be a fast leader, take risks and double down on innovative solutions rather than hanging back and wondering whether changes will endure.
Many healthcare sites have reopened their doors for regular business, but others are walking back their plans as coronavirus cases spike in certain parts of the U.S. We need to determine the best way to triage patients—especially if current trends are indicative of another widespread shutdown. Do we prioritize the patients who delayed their care the longest? Will some patients return faster than others? One thing is for certain, we’ll be on much stronger footing in the future if we can transition from demand-based care to need-based care during the healthcare system reboot.
When the system is focused on reviving the sick, patient preferences take a back seat to outcomes and costs go up. Even though affordability could be a tall challenge for the foreseeable future, we can still work toward a model that focuses on wellness and preventive care. By engaging patients when they aren't sick, we not only keep them well but also achieve better outcomes, improve quality of life and lower costs. With this approach, we’d see patient preferences become the prerequisites for good outcomes, and isn’t that the ultimate goal of patient-centered care?
A long-term transformation plan will lean heavily on powering tools like artificial intelligence with the right data to enable population health management and usher in care delivery improvements, cost reductions and better health outcomes. Data becomes the key to engaging patients in a way that identifies and heads off healthcare events before they happen. In an ideal world, the “right” combination of data would be collected from electronic health records, payer claims, social determinants of health, and consumer health apps. But that approach is not without its challenges: Others have gone down that road and patient privacy rights have pushed them off course.
The pandemic has given healthcare the nudge it needs to cater to patients differently in the future. The true test (once the critical threat of the pandemic has passed) is whether healthcare chooses to stand united or fall divided. In the meantime, let’s focus on how open-minded we’ve been to change, and how quickly we’ve worked together to solve disruptions to patient care.