Healthcare Benefits Changes - Free Paper Example

Introduction

COVID-19 has spurred massive increase in the adoption of telehealth. Undoubtedly, consumer adoption has skyrocketed from 11% of Americans using telehealth in 2019 to 46% in 2020 in replacing cancelled healthcare visits due to the COVID-19 pandemic. Healthcare providers have witnessed 50 to 170 times the patient figures in telehealth than it was prior to the global pandemic. Prior to COVID-19, U.S. telehealth players were recording total annual revenue at an estimated $3 billion, with most vendors emphasizing on “virtual urgent care” section such as acute sinusitis and avoid trip to the emergency department (ED). Spending on health services in the first quarter of 2020 (January through March) was relatively flat overall (Hassan & Mahmoud, 2020).

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Spending was around -0.4% relative to 2019’s first quarter across all health care providers, exclusive of social services and prescription drugs. However, in the first quarter of 2020 spending compared to 2019 was down, spending on nursing homes (5.9%), outpatient care centres (1.1%) but spending on hospitals (-4.1%) and medical labs (-2.7%), (Hassan & Mahmoud, 2020). However, the below chart in reflecting information about the same does not entail the full extent of the global pandemic.

Health Care Providers

Just as was the case in events of September 11, 2001, suddenly altering the way U.S. inhabitants travel, the current Coronavirus is abruptly adjusting the way health care providers deliver and consumers’ reach to services (Bernstein et al., 2020). In the recent months, telehealth rates have exploded massively as the federal government got rid of obstructions to healthcare providers leveraging the solution to patient care outside the office. A new analysis found out that individuals with personal or fully-insured group market coverage are in plans that waived sharing of costs for Coronavirus treatment. However, most of those waivers are set to expire in the next few months.

Virtual care has been critical in screening and treatment of COVID-19 cases from afar. Some of the reasons telehealth is now essential more than ever are; aids in protection of medical team and patients as lots of visits are happening via telehealth; enables radiologists work from home as they use digital technologies; telemedicine has boosted convenience and improved care and disease management in reducing hospitalization rates for high-risk adults; and has pushed specialists in expanding telehealth for critical needs inclusive of telecardiology such as virtual home visits and nurse-aided consultancy at satellite clinics (Bernstein et al., 2020).

Revenue

COVID-19 changed revenue and healthcare utilization generally across the industry and seven specialties as noted by Fair Health in June 2020 in the article “4 stats on how COVID-19 affected healthcare utilization” (Oliver, 2020). Some four insights of data released by Fair Health for the first quarter of 2019 and 2020 to document differences in utilization are; 2019 and 2020 compared, utilization reduced by 65% and professional revenue 45%; oral surgery experienced the greatest downfall in March 2020; relative to other procedures between January and April 2020, office and outpatient evaluation visits gained the upper hand; and, in the first quarter of 2020, vaccination procedures lost their space in the top five codes by utilization (Oliver, 2020).

During the COVID-19 pandemic, the expansion of telemental health has sprung new heights, more especially in comparison to the slow trajectory before the crisis happened. Virtual services have been preferred as they are fast, safe and convenient compared to in-person services. The effectiveness of telemental health is attained on a wide range of modalities such as videoconferences and telephones. However, prior to the pandemic, individuals seeking behavioral and mental health solutions prioritized physically visiting the healthcare centres than telemental health (Hassan & Mahmoud, 2020). COVID-19 has without doubt disrupted mental healthcare delivery though there is a surge of mental and behavioral health care needs arising from the pandemic.

Control Measures

Critical control measures such as social distancing, the timeframe of economic recovery as individuals with lower incomes have inappropriately been disoriented by the pandemic are some of the reasons for increased need for behavioral and mental services. Unfortunately, there have also been precipitous rise in overdose and suicides even among nurses and teachers due to the continuing uncertainties caused by the pandemic. Therefore, since the individuals cannot visit the healthcare centres though in dire need of the services, they have opted using telemental health. However, the Employee Assistance Program (EAP) has been valuable during these moments as they reduce the distractions affecting concentration of employees during the crisis.

The unexpected and sudden lockdown of the U.S. and arrangements for residents to stay at home for the novel COVID-19 outbreak have raised a major concern for patients with chronic diseases. The patients are unable to access healthcare facilities for their regular medicine and care management (Hassan & Mahmoud, 2020). Retail pharmacy outlets have been the only available easy option for the patients to access. COVID-19 pandemic and the resulting economic downtown hit the U.S. at a moment when the unexpected medical bills were already a huge concern for most Americans.

Conclusion

Mail-order or courier deliveries have increased during the Coronavirus lockdown as people get their prescription drugs, a change from the traditional pharmacists visit (Bernstein et al., 2020). With the reallocated cost saving, members plan can be enhanced. Owing to the decrease in elective procedures and routine medical care that has been postponed in light of the pandemic, those resources and funds can be used in better benefiting the members. For instance, individual member future premiums can be reduced, coinsurance, increased employer contribution to the HAS or HRA, or employer could pay for COVID-19 testing as the existing waivers are about to expire. And by so doing, better healthcare benefit changes will by a great magnitude help members in the age of COVID-19.

References

Bernstein, S. W., Buck, charles, Cook, E. J., Geetter, J. S., & Goel, A. J. (2020). After the Curve: An Analysis of the Changing Face of Healthcare. The National Law Review, X.

Hassan, E. M., & Mahmoud, H. (2020). Impact of COVID-19 Second Wave on Healthcare Networks in the United States. https://doi.org/10.1101/2020.07.11.20151217

Oliver, E. (2020, June 11). 4 stats on how COVID-19 affected healthcare utilization. https://www.beckersasc.com/benchmarking/4-stats-on-how-covid-19-affected-healthcare-utilization.html.