An Epidemic of Changes
Matochik: Telehealth, by far, has been the greatest pathway for patients to access care. A recent report from McKinsey & Co., predicts that $250 billion of U.S. health spending could be virtualized based on the COVID-19 rise in utilization. However, there are other ways patients have been accessing care. For instance, community health workers (CHWs) have played a critical role in providing care in the community and nationwide there are initiatives to deploy CHWs to perform contact tracing. In the employer market, companies have ramped up communications about their EAP services so employees know what services are available to them during the pandemic and some have even expanded their offerings. In fact, a recent survey showed that 53 percent of employers are providing special offerings to address the emotional impact of COVID-19. As a result, more employees are utilizing their EAPs.
Smith: Holistic employee safety – emotional safety, financial safety, ethnic/religious safety, etc. – remains the top priority for companies. We will continue to see the healthcare industry leverage technology and data in a myriad of ways, but specifically to support earlier interventions, reengineer primary care, and provide mental well-being services such as contingency management for treatment of substance use disorders. A troubling pattern is the number of individuals who have delayed or skipped care because of the COVID-19 pandemic. New polling from Kaiser Family Foundation (KFF), indicates that nearly half of Americans said that either they or someone in their household has skipped or delayed medical care. Sixty-eight percent expect to get the postponed care within the next three months, and almost all expect to eventually get care. However, of those who postponed care, 11 percent told KFF that they or their family member’s condition worsened. While elective services have decreased, health systems are also seeing decreases in emergencies such as strokes and heart attacks which is also really troubling.
Smith: Some hospitals will not be poised to withstand the financial losses from the current pandemic, leading to an uptick in closures and M&A activity in the coming years. As more systems consolidate, they will gain larger market share making it increasingly more difficult for negotiations. Another trend we are likely to see is an immense amount of care being provided in the home and community. Networks need to consider how they incorporate virtual care and community brick and mortars. FQHCs, primary care settings, and event community-based organizations that provide social services may be administering patient physical, behavioral, and social healthcare and should be considered for reimbursement or a value-based arrangement.
Matochik To pick up on David’s thread on the variety of providers and modalities increasingly being incorporated into network building…from a broker perspective, particularly in the upper middle market and captive settings, being very knowledgeable about the landscape of quality providers and offering data services in this area to self-insureds is a broker imperative if it wasn’t before.