In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.
Following the deadly surge in November and December, COVID-19 cases are now down 77 percent in the United States over the last six weeks. There are numerous factors causing the decline:
Immunity may be higher than suspected. Many of those who were mildly symptomatic or asymptomatic may never have tested for the disease or antibodies. Especially in certain communities early in the pandemic, tests were nearly impossible to secure. Additionally, antibody tests do not look for memory T-cells, which could provide immunity, so even those with no detectable antibodies present may still have natural immunity.
The Centers for Disease Control and Prevention (CDC) estimates 15 to 30 percent of U.S. adults have had COVID. It is possible that even 30 percent is an underestimate, and if we add to that the growing percentage of Americans who have been vaccinated (currently at 15 percent), we may be beginning to reach levels at which the number of people susceptible to coronavirus is declining to a significant degree.
The models for 2021 have thus far been inaccurate. The rapid decline of cases is a positive, but some worry publicizing the good news will cause the public to become lax in social distancing and mask wearing, or even refuse the vaccine. Areas of the country have seen increased complacency during lulls in the pandemic, leading to spikes in the following weeks. We cannot forget all we have learned about pandemic safety simply because cases are declining, but we must also balance the risks of continued closure, like isolation and the safety net provided by in-person schooling, should cases continue to decline.
Throughout the pandemic, the public and private sectors partnered to deliver numerous invaluable contributions to slowing the spread and treating the disease. They rapidly developed new products, increased production of medical supplies, and readily shared information in an attempt to achieve the best outcomes. While many aspects of the response were successful, there are lessons to be learned about how to strengthen public and private collaboration for future public health emergencies, including:
Strengthening public-private collaboration will be necessary to future public health emergencies, but the lessons learned also apply in non-pandemic times. Public-private partnerships can drive improvement in health outcomes. Only 20 percent of many health outcomes are linked to medical care. The rest are attributed to environmental and socioeconomic factors. States and the federal government control a large portion of spend on healthcare through Medicaid and Medicare. Some of the same tactics noted above that may improve response in future crises may also improve response to social determinants of health (SDOH).
New data and commentary were released this week related to the state of physician practices in the United States nearly one year since COVID-19 arrived.
However, in 2020, the in-person visits are shown to have been similar to the fall — and substantially lower in December compared to prior years. This gap is particularly evident for patients aged 3-17 years old, and for certain service lines, including pediatrics, physical medicine and rehab, pulmonology, and otolaryngology, which have also experienced the largest cumulative visit volume declines, of 25 percent or more. Behavioral health has also seen a continued substantial overall drop in in-person visits but has the highest sustained volume of telehealth visits — 56 percent of total baseline visits in December.
The trends evident in the newly released data and analysis suggest that physician practices are on the road to recovery, though there is still a long way to go, and some practices have not made it through this experience. In the PCC survey, nearly 40 percent of those surveyed knew a clinician who had quit, retired early, or closed their practice. Visit volume may be returning, but practices will need to continue to encourage patients to return for postponed care, embrace telehealth (depending on the service) to reach existing and new patients, seek other sources of revenue (such as government funding), and proactively manage costs before they prevent positive margins despite volume recapture.
In addition, many practices that have survived — particularly primary care — are willing to contribute to the vaccination process. In fact, per a recent Green Center Patient Survey cited in the PCC survey, two-thirds of patients expressed that they had trouble finding COVID information they trust, but 80 percent trust their primary care provider. Enabling primary care practices to educate patients about the vaccine and administer it could help close the gap to widespread immunization. However, until vaccine production increases and distribution extends to primary care, this important channel for vaccination will remain impeded.
For many organizations, the tidal wave of change in a relatively short period of time has made it even more challenging to manage — let alone adapt and improve — the most fundamental attributes and indicators that drive performance.
The rapid spread of COVID-19 in rural communities and the pre-existing rural hospital closure crisis have left 453 hospitals vulnerable to closure, on top of the 135 hospitals that have closed since 2010. Our latest research provides a lens into the extent to which the pandemic is impacting rural hospitals.
Health disparities continue to be a pervasive problem within the US healthcare system, leaving healthcare leaders with the question: Are we advancing the ball or taking steps backward? Our Chief Physician Executive Dr. Roger Ray talks about how to thoughtfully move toward health equity for all in this excerpt from Creating a New Healthcare.