An Industry Look at Healthcare in the Time of COVID-19
Everyone has been impacted by COVID-19. There has been press coverage on the multitude of downstream implications on our health, finances, and the way we live.
However, there has not been in-depth coverage of the long-standing impacts of the Coronavirus on our healthcare industry. There are numerous implications that may not be widely known and understood.
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The virus is not widely understood, and there is no cure (yet).
The best scientists and physicians in the medical community are working on this unprecedented virus and how it manifests. However, it continues to surprise us. We do not know why a 90-year-old recovers and a 44-year-old may succumb to the virus. Additionally, many are asymptomatic, making this virus unique and its already-high contagion worse. Children, thought immune from virus symptoms, are now experiencing pediatric inflammatory syndrome.
Currently, there is no official treatment, cure, or vaccine for this disease. Treatments like Gilead’s Remdesivir have produced improvement in patient outcomes, but not dramatic results. The “Warp Speed” rush for the vaccine is underway, with 100 potential vaccines in development from a multitude of industry leaders. Moderna announced their mRNA vaccine had positive Phase 1 results.
However, we are not sure how effective vaccines and treatments will be. Pervasive testing will lead to some clinical answers. Unfortunately, testing remains confusing and is in limited supply. There are a variety of tests for both active Coronavirus and for antibodies. A negative result does not ensure someone won’t be positive tomorrow, and a positive antibody test does not necessarily mean full and lifelong immunity.
The talented scientific community is moving fast, but there is a lot more to learn about this virus. Mitigating its spread makes it difficult for the medical community to care for patients with non-COVID related health needs and manage the virus.
Impacts on healthcare providers are multi-faceted.
After the virus outbreak, healthcare systems and providers were faced with the double whammy of caring for very sick, high-intensity patients and having to shut down a large portion of their traditional business. The ramifications of the disease created a financial crunch for providers. You had overworked physicians on the front lines experiencing inordinate stress and other physicians who had to shut down their clinics. All non-urgent visits and procedures were cancelled.
These procedures are the financial backbone of provider organizations - and significant revenues were lost. Additionally, the job and income loss from COVID-19 leads to decreased demand for non-urgent procedures and visits, due to the loss of insurance coverage and ability to pay.
More positively, some larger health systems and providers demonstrated their ability to be nimble and pivot during these difficult times. They quickly secured PPE, launched telemedicine programs, creatively used technology and protocols to treat COVID-19 patients, and pushed out strong communication campaigns to patients. Smaller clinics were not as nimble.
The CARES Act provides $50 billion in funds to help providers recover, and providers have also implemented campaigns to recover lost revenue. However, demand for services and revenue will likely be lower until the virus is managed and the economy has recovered.
COVID-19 will alter the delivery of healthcare permanently.
The demand for healthcare is permanently changed, and value-based care efforts are likely accelerated. Before COVID-19, the healthcare industry was shifting toward community wellness and population health, while still economically dependent on expensive, invasive procedures and treatments.
The shift to value-based care driven by the government, employers, and insurers was a large focus of provider organizations. The goal is lower cost, quality care that would lead to positive health outcomes. Digital health and telemedicine have become important tools to accomplish that goal.
Digital health and its related venture capital investment grew to $7.4 billion in 2019. Key technologies were telemedicine, remote monitoring, and applications for disease management. COVID-19 has accelerated innovation, implementation, and adoption of these technologies.
Telemedicine companies, like Teladoc, became critical to delivering remote care to patients. Buoy Health, an AI diagnosis symptom checker company, and Livongo, a chronic disease management company, are other examples of relevant technologies to manage health and avoid expensive treatment.
The trend away from expensive, intensive medicine toward remote medicine and digital health solutions is likely to accelerate and continue – as well as the venture capital investment. Cost-conscious consumers have learned not all clinic visits and procedures are necessary – and in an era where all things are instant and economical, digital and remote is likely a preferred model for consumers.
COVID-19 has prompted healthcare providers to adopt these value-based technologies at a faster pace - changing care delivery approaches permanently.
Patients have shifted views of their health and prioritized physical and mental wellbeing.
During this pandemic, we have been forced to address our overall health and mental health needs head-on. Whether it is job or income loss, working remotely, or home schooling, these are significant stresses and change the way we live.
Suicide, substance abuse, domestic abuse, and divorce are often results of individuals' inability to cope with serious circumstances. Our healthcare providers are now patients themselves, given COVID-19 pressures and physician burnout.
We have opened up about our vulnerability and need for self-care. This is a positive outcome of COVID-19, because the mental health and PTSD impacts of this virus have not fully manifested.
The good news: The virus has helped reduce the stigma of mental illness and health. The focus on the mind-body connection will continue with the rise of direct-to-consumer solutions for mental health support, like Meru Health, Calm, and BetterHelp.
Individuals are learning to take care of their physical health and make mental health and wellness a priority. The demand for mental health and wellness services is here to stay.
The Coronavirus introduced significant scientific, clinical, and financial challenges that will permanently change the healthcare industry and the way we live our lives. How we manage our health and mental health and obtain services will be more innovative and efficient going forward.
The biggest change is that consumers are at the forefront of their health – whether wearing a mask or identifying a healthcare need and a service provider. Patient engagement is a real positive that has been lacking in value-based care to date. Providers will have to shift their approach and accelerate their current efforts to meet the new demands from consumers.
Mathilde Leary is the Managing Director of HealthePorte.
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