Our research team breaks down this week’s top healthcare news.
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.
This week, nearly one year to the day after the first COVID-19 case in the United States was confirmed, another grim milestone was reached as the country surpassed 400,000 COVID deaths. Although the United States makes up only 4 percent of the world’s population, 20 percent of worldwide COVID deaths were in the United States, with the majority of those deaths coming this fall and winter after it was already clear social distancing and masking could help to prevent the spread.
Though it is premature to assume that the United States is through the worst of the pandemic based on this most recent shift in indicators, progress is being made. In addition, over the last year, volumes of data have been gathered and studied that are better informing scientists’ theories about COVID transmission and infection detection. The most recent theories include:
Two approved vaccines are being produced and distributed across the United States, albeit slowly and with a number of stumbles. In addition, early studies have shown the Regeneron antibody drug to be protective against infection from COVID in high-risk populations.
However, we are not near the finish line quite yet. As Joseph Allen, director of the Healthy Buildings Program at the Harvard T.H. Chan School of Public Health, stated recently, “We have to still deal with ‘the right now.’ We’ve zeroed in on this set of controls that we know work.” Based on the learnings above and the “set of controls” that have proven helpful, the U.S. population not only has to be diligent through these next several months but also must use new knowledge to better prevent the spread of the virus. There may be less need for constant surface cleaning and sterilization, while improving indoor airflow and increasing adherence to mask-wearing (even doubling up on masks, as was recently suggested by scientists in a piece in The New York Times) may be even more crucial because of its efficacy in preventing transmission. Developing less expensive rapid tests to use on broader populations may be more useful to detect cases in places where the virus could be transmitted, such as workplaces, schools, airports, and hotels, as opposed to the current common mode of dutifully taking temperatures and asking people to complete questionnaires about recent coughs or congestion.
Finally, despite the improved understanding about some aspects of COVID, much is still to be learned about this virus, particularly around how it affects different populations and which treatments produce the best outcomes for those infected. HCA Healthcare, the Agency for Healthcare Research and Quality, and a number of universities recently formed a research consortium that will utilize patient data from HCA and other consortium members’ hospitals to study the demographics of patients who contract COVID, the role of pre-existing conditions, and the efficacy of treatments currently in use. It is hoped that this and other similar consortiums may open up collaborative learning possibilities beyond COVID.
Physician consolidation — into larger physician groups, clinically integrated networks, hospital-physician organizations, and other structures — has been increasing for years. Recent data published in Health Affairs shows that the average change in share of physicians in health systems between 2016 and 2018 was 8.8 percentage points at the metropolitan statistical area level (the median change was 7.4 percentage points). Given the recent financial devastation in many physician practices as the result of temporary closure due to COVID-19, the number of physicians seeking support will likely continue to grow, further increasing consolidation. A recent Medical Group Management Association (MGMA) poll revealed that the top five changes experienced in physician practices in 2020, which will be areas of concern or focus for 2021, were: (1) staffing (adequate staffing levels as well as mental health and morale support); (2) financial performance (increasing costs and revenue constraints); (3) practice transformation (including mergers and acquisitions); (4) technology implementation; and (5) operations improvements/practice efficiency. The need to focus on change management was underscored as crucial in MGMA’s analysis and commentary, given the unusual and disruptive year experienced in 2020.
As physician practices enter a new calendar year, they face a multitude of challenges brought on or exacerbated by COVID. Facing these challenges is daunting. At the same time, the increase in physician burnout through COVID has been shown in several studies and is forecasted to increase before it is alleviated, per the recent annual MedScape National Physician Burnout and Suicide Report. Physician “happiness” dropped from 69 percent pre-pandemic to less than 50 percent. One-tenth of physicians reported that the current level of burnout may lead them to leave the practice of medicine. With myriad challenges facing physicians and burnout persisting and growing, many more practices will likely seek support from larger organizations. Health systems and larger physician groups have an opportunity to grow their employed physician base if they can offer the right mix of technological, operational, and financial support to these struggling physicians and practices. Providing mental health and wellness support, or offering to work with physicians to address or mitigate the root causes of burnout (e.g., too many bureaucratic tasks, cited as the largest contributor in the recent MedScape survey), may make joining a system an even more attractive option.
Data & Analysis
As the COVID-19 pandemic endures, health systems across the country head into the second half of 2020 with margin improvement as a top priority.
Non-traditional entities are capturing the value void through innovative models, partnering with funding entities to receive compensation for addressing needs. What activities and strategies should health systems consider?
With a growing acknowledgement of the longevity of COVID-19, the workforce will need ongoing support as they try to cope with the anticipated peaks and valleys of the curve, which will continue until there is an effective treatment or vaccine.