By Mary Lou Mangan-Lamb, MedeAnalytics
The Centers for Medicare & Medicaid Services (CMS) announced the delay of all elective surgeries, non-essential medical, surgical, and dental procedures during the Novel Coronavirus (COVID-19) outbreak in March. Then in April, CMS offered specific guidelines encouraging providers to prioritize health needs based on a three-tier system. Postponement of services could be considered for low acuity services or treatments, such as wellness visits and exercise therapy. A telehealth evaluation, possibly followed by triage to a facility, could be considered for intermediate acuity services or treatments, such as pediatric vaccinations and non-urgent symptoms consistent with COVID-19. For high acuity treatments or services such as serious symptoms in a new patient or indications of severe disease, CMS urged providers to triage to an appropriate facility.
In addition to the guidance from CMS, the Centers for Disease Control and Prevention (CDC) encouraged providers and facilities to implement service delivery models such as telemedicine. This was suggested as a measure to preserve staff, personal protective equipment (PPE), beds, and ventilators.
These recommendations had a profound effect on the U.S. healthcare system. In an April article published by Texas A&M University Health Science Center, the organization estimated the U.S. experienced a 50 percent reduction in surgeries. The American Hospital Association (AHA) calculated the impact of COVID-19 on the healthcare system at $200 billion from March until June of this year. This includes the net financial impact of COVID-19 hospitalizations ($36.6 billion), revenue losses from canceled surgeries and other services ($161.4 billion), costs associated with purchasing PPE ($2.4 billion) and the costs of other support some hospitals are providing, such as childcare, housing, and transportation ($2.2 billion).
When Will Patients Be Ready To Receive Care?
CMS issued new guidelines on April 19 for re-opening facilities to provide non-emergent non-COVID-19 care. CMS recognized the need to restart care, including surgeries and procedures, chronic disease care, and preventive care. One of the immediate challenges to the healthcare system is getting patients to return to facilities. The American College of Emergency Physicians found four in five adults report they are concerned about contracting COVID-19 from another patient or visitor if they go to an emergency room. Twenty-nine percent of adults have delayed or avoided seeking medical care due to COVID-19 concerns.
As providers determine how to get patients to return to facilities for routine disease management and preventive screenings, opportunities are ripe for the application of analytics to triage at the right time to the right setting. Data related to COVID-19 will continue to flow rapidly, but there are possibly more questions than answers now about a return to “normal.” Health systems will have to use data to identify the patients needing immediate care when facilities re-open. Will they be able to utilize predictive analytics to identify the levels of care needed? The hope is predictive analytics will be used to its highest capacity to help.
The coming months will continue to test our healthcare systems in a multitude of ways, but data will be crucial for every level of decision making and long-term success.
About The Author
Mary Lou Mangan-Lamb is a director of Product Consulting at MedeAnalytics.