Outpatient volume in the second half of March declined more than 65 percent, according to Premier data, a sign of the financial and operational straits medical practices have weathered during COVID-19. Premier’s medical group data, which includes more than 30,000 providers, compared outpatient visits in the latter half of March to the average weekly volumes practices logged from September 2019 to February 2020.
For practices experiencing such a decline in ambulatory activity, or even those that have been functioning at half capacity, the thought of coming back online may be daunting. As the pandemic recedes, many practices will be starting from scratch, rehiring the majority of their staff, rescheduling appointments and restarting their supply chains. Given the pent-up demand for appointments, planning and execution for post-pandemic surge will need to occur rapidly. However, it will not be as simple as returning to operations as they were prior to coronavirus
Our learnings thus far tell us that industry leaders will need to think very differently about traditional practice operations moving forward.
COVID-19 has shifted the norms and expectations of patients and providers, alike. Practices that operate in the summer of 2020 the same way they did a year ago would be acting oblivious of the concerns and anxieties patients are carrying with them after the outbreak.
Coming out of the crisis, medical group leaders’ efforts will need to be well-coordinated and address the following critical areas:
- Patient access and scheduling – The alignment of appropriate infrastructure, processes and resources are in place will be necessary to enable practices to quickly respond to and resolve the influx of requests for patient appointments.
- Practice operations, staffing and space Utilization – Tactical responses should be designed to address new and shifting values, such as physical distancing, with respect to patients, families, caregivers and providers.
- Clinical services and ancillary coordination – As practices schedule outpatient visits, they should simultaneously plan how to scale laboratory, imaging and testing-related services to meet surges in demand and enable efficient, and at times physically distant, flow of patients to treatment.
- Provider compensation and team wellness – There will be impacts to provider earnings, and leaders must identify means by which to address losses while attending to the needs of the care team.
- Virtual technologies – In stark contrast to physical preparedness and readiness, practices may seek to have upwards of 80 percent of their clinicians capable of offering remote options.
- Financial management and stimulus resources – A review of relief or funding programs, and deployment of targeted, short- and long-term operational and financial strategies, should be set in rapid motion to help offset losses.
Four Changes in Perspective that are Forcing Changes in Care Delivery
Never before has the healthcare industry seen forces shift both provider and patient values to this degree. In many instances, patients may eschew new processes or technologies in favor of traditional methods, and medical groups will need to reevaluate the basic operating guidelines that have led historical decision-making.
Here are four process changes for which medical group leaders should prepare:
I Don’t Want to Wait (On Site)
The new normal may be that patients don’t want to physically wait in clinical areas due to exposure and infection concerns. Additionally, patients will be more conscientious of visiting or transferring between multiple clinical areas due to greater risks associated with increased contact. Don’t be surprised if patients prefer to wait in their cars or open areas while requesting to be notified via cell phone when their provider is ready.
It’s Not You, It’s Me
While kiosks, iPads, portable pagers and self-service payment devices all have proven to be enablers in the past, many patients will elect not to touch or come into contact with these. And it’s not just patients; providers and staff are also equally worried about these interactions and the associated risks.
I’ll Call You
While providers have longed for more patient interaction since the emergence of the electronic health record (EHR), it might just be preferential to conduct virtual visits to reduce unnecessary interactions. Health systems and providers racing to stand up and scale these technologies, however, are finding that hurdles may include telehealth integration with the EHR, reimbursement queries and the potential for lower ancillary volumes and revenue.
Don’t be surprised if community members begin to revert to the mentality of earlier generations, when people often refused to go to the doctor unless they were extremely sick. The current economic climate coupled with new patient fears and ongoing high-deductible health plans are likely to lead to medical avoidance for a period of time. And for the patients who require an in-person clinic visit, it’s likely that health systems will create new guidelines and limitations imposed on family members or individuals that wish to accompany them.
Given these dynamics, organizations are addressing these new challenges in a multitude of ways such as:
- Asking patients to wait in parking areas or cars for their appointments instead of clinic spaces.
- Leveraging virtual health, which enables providers and patients to maintain connection and appointments regardless of the degree of physical separation, and may also conserve supplies such as masks.
- Scheduling symptomatic patients during a specific block of time at end of the day, to allow for a safer evaluation and more efficient throughput of non-symptomatic patients earlier in the day.
- Instituting drive-thru testing for patients suspected of COVID-19, a system that may have the potential to be used for other medical conditions as well.
Chart Your Path Forward Post-Pandemic
On May 1, a panel of participants from Premier hosted a webinar, “A Medical Group Leaders’ Guide to Navigating Post COVID-19,” to provide an actionable framework for navigating the current and post-COVID-19 effects on ambulatory operations. Given the unprecedented level of appointment cancellations and the dramatic drop in practice wRVUs, demand will likely surge post-crisis as patients aim to quickly schedule routine diagnostic, preventative and other elective appointments. As such, now is the time for practices to begin planning a strategic, thoughtful response for their return to operations.
Watch the webinar on-demand now.
Unwavering Support and Partnership
During COVID-19, Premier continues to act as a trusted connection point for healthcare providers, suppliers and the government. We are working 24/7 to address challenges as they occur and help our alliance of more than 4,000 hospitals and health systems and 175,000 non-acute providers access the supplies they need to serve their communities. We are also partnering with the Administration and private sector to create short-and long-term solutions.
Access our COVID-19 resources and tools.