The global COVID-19 pandemic has altered the workflow of all healthcare providers and urologists are no exception.
Providers faced new federal and state mandates as well as the economic hardships. They adjusted through a sharp decline in patient visits and elective procedures created by fear of exposure or loss of insurance due to job losses. These impacts will last for months or years, even as vaccines are distributed and the pandemic begins to slow.
1. Continued demand and access to telehealth. This is perhaps the “most substantive change” to healthcare delivery during the pandemic, according to Urology Times.
The use of telehealth has declined from its all-time high reached earlier in the pandemic and will continue to do so as we emerge from it. But virtual care will be utilized at higher levels than before the emergence of the novel coronavirus.
By the end of 2020, nearly half of all states had passed legislation extending telehealth waivers beyond the pandemic.
Urology patients tend to be older and therefore at higher risk of hospitalization or death from COVID-19, so it is likely they may choose to wait longer before returning to doctors’ offices. A study out of the department of urology at the University of Virginia School of Medicine found that the rapid implementation of teleurology is both feasible and highly accepted by patients.
2. Accelerated shift to value-based care. A drop in elective procedures meant a financial hit to providers, especially those dependent on traditional fee-for-service models, which rely on large volumes of procedures and provides little incentive to improve the quality of care. Value-based care incentivizes providers to offer the best care at lower cost.
Like the first trend, a shift to valued-based urology care had already started before the COVID-19 pandemic caused it to accelerate. What the coronavirus has done is help "shift the notion that joining value-based payment arrangements requires taking on significant downside risk.”
Some physicians who participate in fee-for-service models hinging on patient volume "are rethinking the concept of risk.” And that could accelerate as the Biden Administration works to close healthcare coverage gaps and tie costs more directly to outcomes.
3. Continued attrition of commercial plan payers. An estimated 15 million Americans lost their health coverage during the COVID-19 pandemic, sparking a migration to government-run programs such as Medicaid.
Will Congress provide aid to state and local governments? That will impact how enrollees are distributed in commercial or government-run plans, according to Urology Times — if the economy stays bumpy and the feds don’t step in to stabilize budgets, states may need to reduce the number of people covered by Medicaid and healthcare exchange programs.