Chartis Top Reads – Week of August 23-29, 2020

Our research team breaks down this week’s top healthcare news.

Top Reads Overview

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: clinical quality and risk, 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.

Digital and Advanced Technology

The Buzz This Week

COVID-19 has provoked the need, and often patient preference, for digital care solutions. Telehealth usage has seen dramatic growth in the past six months and offered some providers an opportunity for potential revenue recapture. The American Hospital Association is now asking the Trump Administration to make many of the telehealth changes permanent and to develop a payment system for audio-only telehealth services. Further, digital therapeutics may also play a bigger role in clinical care going forward as part of a solution for pain and psychologic conditions that COVID-19 has exacerbated.

Why it Matters

Many of the regulatory changes enacted regarding telehealth — for example, not requiring telehealth visits to be with providers who have a previously established relationship with the patient and expanding services offered through telehealth and payment parity — were enacted temporarily because of the pandemic. Eliminating these measures, particularly reimbursement, would be a disincentive for providers to continue to expand telehealth services to the detriment of patient access.

Financial Sustainability

The Buzz This Week

Physicians, hospitals, health systems and other care segments have been ravaged financially by the COVID-19 pandemic, in significant part due to the government directive on halting elective surgeries. Perhaps the hardest hit group of hospitals were rural health facilities already operating on razor-thin margins pre-COVID, many of which are now at risk of closing. Other vulnerable entities include nursing homes and assisted living facilities because of the increased cost of PPE and staffing to operate. A study by the American Health Care Association found 72 percent of responding nursing homes and 64 percent of assisted living facilities indicated they "can’t sustain another year at the current pace of increased costs and revenue loss." New CMS COVID-19 reporting requirements could also cause a potential hit to providers’ bottom lines.

Why it Matters

Providers are rapidly trying to ramp up activities to tackle the backlog, address new demand and in many cases pay back what was borrowed from Medicare. In rural communities, critical access hospitals that are unable to overcome the financial losses face closing. Closures have shown to increase the mortality rates in surrounding communities. In nursing homes and assisted living facilities, PPE has been in short supply, and what is available has raised expenses dramatically. Staff is not able to care for these vulnerable patients without proper protection, but the cost of that protection has eroded the bottom line. Fifty-five percent of nursing homes are currently operating at a loss. Amidst the ramp-up, providers are now facing reporting requirements for COVID-19, with the penalty for non-compliance being withdrawal from Medicare and Medicaid. The American Hospital Association has criticized the requirements at a time when hospital revenue is desperately needed.

Provider Enterprise

The Buzz This Week

The impact of COVID-19 can often linger far beyond an initial diagnosis in certain patients, sometimes referred to as “long-haul” patients. In order to better treat these patients, some hospitals have opened specialized clinics. These specialty clinics, while extraordinarily valuable, are quickly developing very long wait times. Additionally, many of the “long-haul” patients that need specialized care face additional access issues due to never having received a positive COVID-19 result because tests have been limited. Adults are not the only population facing lingering issues. While the majority of children seem to recover quickly, one study of 14- to 20-year-old patients found that 10 percent had persistent respiratory issues beyond 17 days.

Why it Matters

COVID-19 patients with ongoing symptoms will need integrated continuing care. While it is unclear what percentage of patients have “long-haul” symptoms, there is currently a material shortage of specialized COVID-19 long-term clinics to meet demand, with many already booked two to three months in advance. That demand is only likely to increase with additional positive cases, as well as patients that were initially antigen negative but who now have positive antibody tests and need care. Additional information and studies are needed on the pediatric population to understand what long-term effects may be.


Contributors

Roger A. Ray. MD
Physician Consulting Director
[email protected]

Alexandra Schumm
Principal, Vice President of Research
[email protected]

Abigail Arnold
Research Manager
[email protected]


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Chartis Top Reads - Week of August 23-29, 2020 - The Chartis Group