Hindsight is 2020: How the Pandemic Impacted Our Year in Healthcare, and What Trends to Look For in 2021
As the turbulent whirlwind of 2020 draws to a close, there is much to be learned from this transformative year for healthcare. The future looks bright as COVID-19 vaccines are being approved and released - giving hope for the end of the pandemic and some form of return to normalcy in mid-2021. Yet the pandemic has spurred so many groundbreaking changes in healthcare, many of which are poised to grow and expand even after widespread vaccine adoption. Let’s take a broad look at some exciting industry trends to watch for in the New Year.
Refinement of Virtual Care
Virtual care exploded nearly overnight this year as the restrictions on telemedicine were relaxed due to the pandemic. The spike in telehealth visits has been staggering – with more than an 8,000% increase in claims filed for telehealth services by mid-2020, as compared to 2019 [7]. Many telehealth implementations were expedited and haphazard, and many organizations are now refining their processes.
The Joint Commission has expressed interest in measuring patient outcomes from telehealth, and possibly instituting quality measures to verify continued quality and safety of patient care in the virtual setting [2]. Clinicians are also learning new skills to navigate virtual care. Bedside manner has even evolved into the newest term “webside manner”. Meaningful relationships and authentic patient experience will always be important- whether virtual or in-person with social distancing – it just looks much different than it did last year. 2021 should be the year for continued advancements in telemedicine, establishing best practices and eliminating options that just don’t work.
For more on virtual care, LISTEN TO OUR PODCAST INTERVIEW with Twilio’s Global Health of Healthcare Service, Susan Lucas Collins. Here’s a snapshot of some positive experiences she describes from observing telemedicine adoption:
“I had a pediatric specialist say to me that seeing a patient in their room, with posters on the wall and toys and things that were important to that kid, made for a far richer interaction than they expected. I think that’s a huge benefit that we’ll take away from telemedicine: better understanding of how to create better human connections between providers and patients. We want technology to be ambient, not intrusive to the circle of care. "
Decrease in Hospital Utilization
COVID-19 has hastened the movement of care to the outpatient setting. Hospital stays have become shorter in recent years, with more care completed in clinics and ambulatory centers, but the pandemic has sped up this trend exponentially. Patients have been seeking alternate methods of treatment, rather than visiting emergency rooms to avoid potential exposures. Home care, remote patient monitoring and telemedicine have become the first choice for many. Over the course of 2020, emergency department visits have dropped 42%, outpatient visits have declined 35%, and inpatient care is down 22% [3].
The Forrester report of 2021 predictions mentions that hospitals will likely turn to
“Offering more care at home, which can make hospital care more affordable and reduce readmission rates.”
The loss of hospital utilization is expected to cost health systems $350 billion in 2020, which can be the impetus for new HEALTH CARE MODELS in 2021 [3].
Read our article HERE on the rapid expansion of the hospital-at-home model of healthcare.
MA Plans Add Virtual and Home Care Benefits
Supplemental benefit programs offered by Medicare Advantage plans are also moving with the times. Cost savings of home care over hospital care provide significant cost savings for health plans (as well as better patient outcomes), and the menu of benefits are reflecting that. There are two major pathways that CMS has carved out for the home care industry – the primary health-related pathway, and the Special Supplemental Benefits for the Chronically Ill (SSBCI). According to CMS data, 2021 will see 730 MA plans to offer expanded primary benefits in 2021, up from 500 in 2020. Home Health Care News reports that 920 MA plans will be offering SSBCI benefits in 2021, compared to 245 plans in 2020. An impressive four-fold increase!
SSBCI includes in-home supportive services, but also transportation help, nutrition assistance, and any other services that help chronically ill patients stay home instead of going to the hospital. Another much-needed benefit for MA enrollees is increased access to palliative care and integrated hospice care. The health impacts for Medicare patients should be incredibly positive, as well as secondary impacts to wallets in the form of reduced premiums and drug costs [6].
High demand for Mental Health Services
A rising need for mental health services marks a troubling effect residual from 2020 pandemic conditions. The CDC reports a concerning increase in pediatric mental-health-related ED visits. Compared with 2019, visits by children ages 5-11 increased by 24% and the 12-17 age group increased by 31% (4). Adult visits have had a similar upward trend. Some reasons given include increased stress from stay-at-home orders, loss of income, abusive conditions in homes, lack of social interaction, addiction, and exacerbation of pre-existing mental health issues. Another sub-set of the adult population, healthcare workers, are experiencing high levels of stress and mental health crises.
This disturbing movement is likely to continue well into 2021 and is becoming a secondary public health crisis. Usage of mental health services via telehealth is increasing and allows rural settings and other areas of shortage to have more access to behavioral health services than they did pre-pandemic. Telehealth services are an important strategy for increasing access for groups that - through the study of social determinants of health - we now know have been overlooked. Demand for therapists, psychiatrists, and mental health nurse practitioners will be higher than ever before. Mental wellness, anxiety and stress reduction products, and health coaching are all industries that may be poised to be remarkably busy in the new year.
Healthcare a consideration in all industries
As people begin to leave their remote offices and some return to brick-and-mortar jobs in 2021, the awareness of health precautions will linger. Infection prevention is not a subject for hospitals and other healthcare settings anymore – it is a concern at the top of everyone’s mind. Forbes tackles this subject in its 5 Biggest Healthcare Trends in 2021, stating that healthcare will be a consideration in every aspect of life.
“In 2020, every company has had to become a tech company as data and computing have become essential to everything we do. In 2021, every company will learn to become a healthcare company, too, as safeguarding employees and customers becomes a core requirement of doing business.”
Biosecurity measures, sanitization stations, and screening technology will likely join improved safety measures to reduce the likeliness of illnesses being passed around in the future [5].
Conclusion
Technology has become a huge part of our lives, and now our health. The industry will continue to develop in new ways, finding the most effective means to serve our healthcare needs. Movement of healthcare resources to home, outpatient, and virtual settings is likely to continue and become more the norm. The secondary effects of the pandemic will continue to manifest themselves, and mental health resources will be needed. Return to pre-pandemic activities and jobs will hopefully be possible but will look different and provide more safeguards. The lessons learned from 2020 will certainly stay with us and influence future innovations. Looking back, this will be the year that mobilized healthcare towards an unprecedented tech adoption, rapidly advancing to meet the needs of the world. The medical community stands ready to march towards each new challenge, and the future, finally, is looking a bit brighter.
Sources:
1. Demand for virtual mental health care is soaring. Here are key trends on who is using it and why. (2020). Retrieved 14 December 2020, from https://www.fiercehealthcare.com/tech/demand-for-virtual-mental-health-soaring-here-are-notable-trends-who-using-it-and-why
2. Joint Commission Issues Telehealth Safety Advisory. (2020). Retrieved 11 December 2020, from https://www.medscape.com/viewarticle/939310#:~:text=The%20Joint%20Commission%20also%20advises,conditions%20can%20be%20managed%20virtually.%22
3. Ladika, S. (2020). Forrester's 2021 Prediction: Watch Out In-Person Care, the Telehealth Surge Will Continue. Retrieved 11 December 2020, from https://www.managedhealthcareexecutive.com/view/forrester-s-2021-prediction-watch-out-in-person-care-the-telehealth-surge-will-continue
4. Leeb, R., Bitsko, R., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K. (2020). Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(45), 1675-1680. doi: 10.15585/mmwr.mm6945a3
5. Marr, B. (2020). The 5 Biggest Healthcare Trends In 2021 Everyone Should Be Ready for Today. Retrieved 11 December 2020, from https://www.forbes.com/sites/bernardmarr/2020/11/23/the-5-biggest-healthcare-trends-in-2021-everyone-should-be-ready-for-today/?sh=4ffde0fa21c0
6. New CMS Data Highlights ‘Massive’ Expansion of Home Care-Related Medicare Advantage Benefits - Home Health Care News. (2020). Retrieved 11 December 2020, from https://homehealthcarenews.com/2020/09/new-cms-data-highlights-massive-expansion-of-home-care-related-medicare-advantage-benefits/
7. Telehealth Claims Spike More Than 8,000% Amid COVID-19 Pandemic, Government Waivers - Skilled Nursing News. (2020). Retrieved 11 December 2020, from https://skillednursingnews.com/2020/07/telehealth-claims-spike-more-than-8000-amid-covid-19-pandemic-government-waivers/
8. Trzcinski, A. (2020). Healthcare Predictions 2021: Digital Goes Mainstream. Retrieved 11 December 2020, from https://go.forrester.com/blogs/healthcare-predictions-2021/
