COVID-19: How the Coronavirus Will Forever Change Health Care
Written by Joshua Kleinstreuer
IN A NUTSHELL:
- Telehealth to become routine form of care
- Nursing homes will be a thing of the past
- Facilities will be held to a new standard of preparedness
The coronavirus has already altered many aspects of our daily life and some changes, especially in health care, are likely to be permanent.
It is still too soon to know how the pandemic will affect schools and business as they begin to reopen. However, it is undoubtedly evident that the coronavirus will alter how we think about health care at all levels of the industry.
The pandemic has caused patients, providers, and health care workers in all sectors of the industry to reconsider their operations. This includes office visits, payments, types of services, levels of care, and of course health care administration workflow.
COVID-19 has already caused massive changes, directly and indirectly, relating to who can receive health care as well as how they receive it.
For instance, the country has lost more than 20 million jobs since mid-March, resulting in a level of unemployment not seen since the Great Depression.
In turn, this causes millions of Americans to be without health insurance. Even for everyone that is fortunate enough to still have insurance, many have been forced to delay non-critical treatments, despite the fact that they still may be necessary.
The United States accounts for more than 20 percent of all COVID-19 cases in the world. The effects of the pandemic have resulted in more than 120,000 deaths in this country alone. Many health care facilities are facing supply shortages, staffing shortages, and health care administration is overwhelmed.
Politicians, industry experts, economists, and others alike agree that the “new normal” for health care in America will likely change for decades to come—if not forever:
The advantages of telehealth and telemedicine are moving to the forefront. Congress included $500 million for the use of telehealth services in its emergency COVID-19 aid package passed toward the beginning of March. While the changes mostly involve primary care, experts said the telehealth trend is increasingly applicable to specialists. Mental health services are needed now more than usual, and psychologists and psychiatrists have using telehealth to treat their patients. The technology is also expanding patient access to care in areas that need it most, such as rural America.
Health insurance from employers:
Health insurance companies across the country are expanding coverage and providing greater access to health care services. Lawmakers recently eliminated patient cost-sharing for COVID-19 diagnostic testing services provided under employer-sponsored group health plans, as part of the Families First Coronavirus Response Act. Additionally, many health insurers have waived the customer cost-sharing and co-payments for hospitalization and other costs to treat the virus. Some experts believe that in the near future the public will begin to see an increase in health reimbursement arrangements (HRA). An HRA is a form of health spending account provided and owned by an employer and replaces providing insurance to employees as a company. The money in an HRA pays for qualified expenses, such as medical, pharmacy, dental and vision. Which expenses are qualified is determined by the employer, as is whether or not unused funds will roll over from one year to the next year. Additionally, the employee does not pay taxes on money that comes from an HRA. Proponents say an HRA gives employees more flexibility, yet others believe an HRA offers employees less assistance with their medical expenses than a traditional employer-based insurance.
In many states, deaths in nursing homes and other long-term care facilities have accounted for a large percentage of deaths related to COVID-19. Confirmed cases have topped more than 100,000 with approximately 30,000 deaths.
Experts say the numbers could change the present-day perception about long-term care. While assisted living facilities offer benefits such as 24-hour care and specialized services, placing a high-risk demographic in consolidated living spaces is no longer seen as favorable as it once was.
This will of course cause an increase in demand for home health aides and nurses working outside of the hospital setting. Such a shift is not new and was already on the rise before the COVID-19 pandemic. The health care industry made history in the last quarter of 2018 as it surpassed both manufacturing and retail to become the largest source of jobs in the United States.
The trend is set to continue with an addition of more than 3.4 million health care and social assistance jobs between 2018 and 2028, according to the Bureau of Labor Statistics (.pdf).
Currently, the two fastest-growing occupations in health care are personal care aides and home health aides. The trend will increase even more as the industry adjusts to the pandemic and we could see an end to long-term care facilities as we know them today.
New standard of preparedness:
The pandemic has necessitated immediate action for an improvement of disaster readiness and preparedness across the United States. The fallout from the effects of the virus has proven that dealing with a health care emergency of this magnitude is unlike any natural disaster we have witnessed in recent history. Undoubtedly, the country’s health care infrastructure wasn’t prepared. It began with the inability to conduct testing in the necessary capacity and was followed by health care facilities overwhelmed with patients whilst lacking the staff for treatment, administration, and operations.
The industry has realized the need for more efficient administration, effective and compliant communication, and the ability to call upon networks of retired physicians or medically trained members of the armed forces.
The magnitude of patients being hospitalized due to the effects of COVID-19 has caused unprecedented capacity levels for emergency rooms and intensive care units. Consequently, it has also brought to light the importance of allied health professionals such as nurses, nurse practitioners, and physician assistants.
Scope-of-practice laws are state-specific restrictions that determine what tasks nurses, nurse practitioners, physician’s assistants, pharmacists and other health care providers may undertake in the course of caring for patients.
The hurdles and consequences surrounding scope-of-practice laws are not new. The rules restrict the supply of primary caregivers, a problem which is widespread across rural America. This leads to increased costs, longer wait times, and patients who have to travel longer distances to see a doctor.
As the health care industry continues to adjust their practices in order to handle COVID-19, more medical facilities could utilize the skills of allied health professionals and provide care at a lower cost to more patients if the governing bodies that control scope-of-practice laws allow them to do so. Consequently, health care administrators will need to ensure they have the capability to complete administrative tasks such as credentialing in the most efficient manner possible and understand the increased risk that correlates with allied health professionals performing the same tasks as a physician albeit less experience.