What Health Spending Issues Will We Need to Address Post-Pandemic?
May 20, 2020
With the COVID-19 pandemic, many of our Going Below The Surface (GBTS) Forum partners are on the front lines of health care, working to treat patients and share accurate information with their constituencies while social distancing with their families. They’ve seen firsthand how the current environment has exacerbated existing problems with our health care system, created new challenges, and even brought to light areas that are working. Given their experiences, we asked our GBTS partners about the health spending issues we’ll need to address during the next few months, once states begin allowing more businesses to open and relaxing social distancing measures.
Several GBTS partners weighed in on COVID-19 and health spending and how we’ll need to think differently going forward:
Ceci Connolly, President and CEO, Alliance of Community Health Plans:
“The COVID-19 outbreak cast in sharp relief the flaws in a volume-based, fee-for-service system. Health organizations that run on a capitated payment model, or at least a value-based approach, found themselves on sounder footing with revenue flowing even as elective services were halted. These organizations did not have to scramble for cash or furlough employees but rather focused on patient care, largely through telehealth.
“The outbreak was just the latest reminder that as a nation we have not invested sufficient money into social needs and inequities. A stronger safety net of housing, transportation and food supports, etc., would have positioned many to have better weathered this storm.”
Jerry Penso, President and CEO, AMGA:
“Revenue declines due to decreased volume of office visits and procedures have been massive and are expected to continue through 2020. Combined with the increased expenses due to testing and treating COVID-19 patients, the impact on provider finances has been devastating. We are hearing from AMGA members that in planning for the post COVID-19 world, a focus on how to reduce expenses in delivering care is necessary. This will mean re-evaluating their physical footprints, staffing models, and compensation. Second would be finding the proper role of telehealth in delivering care. In response to COVID-19, providers rapidly deployed telehealth and are currently planning for it to remain a critical component of care delivery.”
Mary R. Grealy, President, Healthcare Leadership Council:
“The COVID-19 pandemic has heightened concerns over the role of chronic disease in driving health care spending increases. Patients with comorbidities face a higher risk for serious complications if they fall ill with coronavirus. And, with millions of Americans losing jobs, a loss of health coverage means they have greater difficulty accessing the resources they need to protect their health and well-being. This places an already vulnerable population in further jeopardy, increasing the utilization of expensive health interventions. Our priority must be ensuring that individuals with chronic conditions have the coverage and tools they need to manage their health.”
Michael Thompson, President & CEO, National Alliance of Healthcare Purchaser Coalitions:
“COVID-19 will exacerbate spending in two key areas that are central to patient health. Chronic conditions will end up being more expensive due to an escalation of social determinants factors (affordability, transportation, food deserts) and less effective personal risk management, as well as a growth in co-morbid mental health issues. At the same time, the lack of preventive services and early detection will cause some conditions (e.g., cancer) to be caught later in the disease cycle, resulting in conditions that are more severe and costly than if they were caught earlier.”
Clif Gaus, ScD, President and CEO, National Association of Accountable Care Organizations:
“As we slowly recover from the pandemic, population health will be more important than ever. We know that providers who participate in value-based care models have been better positioned to handle their patients during the pandemic. And with the expected surge in patients with exacerbated illness who haven’t received the care and screenings they needed but went without during the pandemic, accountable care models will be needed more than ever to provide better population health management. Policymakers and payers need to support these models so they’re as strong as ever when we get out of this.”
Marc Boutin, JD, President, Chief Executive Officer, National Health Council:
“As the country and the world begin to reopen, we need to ensure sufficient workforce and infrastructure to address and mitigate a COVID-19 resurgence while simultaneously addressing a return to routine care by the millions of people with chronic conditions. Additionally, we need to evaluate the impact of telemedicine and other innovative approaches to care on the outcomes that matter to patients and their family caregivers, quality and costs.”
Robert Dubois, Chief Science Officer, MD, PhD, National Pharmaceutical Council
“Although the world feels very different, the principles of how we view the value of a treatment and innovation have not changed. We’re still using the same economic principles of costs and benefits, and the amount that we are willing to spend to save a life – or a year of life – should not change. What will change is an appreciation of productivity and its impact on the value of health care treatments. Because of social distancing and teleworking, there’s a better recognition that chronic conditions affect productivity, and ensuring access to care – and placing value on that care – is paramount.”
Each day the COVID-19 situation continues to evolve, especially as we learn more about the virus, research and develop potential treatments, and consider when it might be safe to relax social distancing procedures. As new information becomes available, GBTS Forum partners remain committed to understanding and considering ways to address health spending challenges and improving our health care system.