The U.S. healthcare system has been facing several longstanding, complex challenges, including rising costs, inequitable access to care, overuse of care, supply chain weaknesses, and staffing shortages. COVID-19 only accelerated them, changing the healthcare landscape. One study estimates that hospitals will lose at least $54 billion in 2021 due to the pandemic.
As the world prepares for a post-COVID-19 era, the healthcare sector has already changed in four important ways: increased reliance on digital healthcare tools, the broader use of telehealth, shifts in the healthcare model, and a growing focus on public health.
For aspiring healthcare leaders looking to manage complex industry challenges, a degree in healthcare management can be a vital tool for understanding the legacy of the coronavirus and how it has accelerated change in the industry.
1. Digital Healthcare
Digital technology had already made inroads into healthcare before COVID-19. However, doctors and hospitals found that digital tools helped them meet the challenges of the new normal. Everything from scheduling and billing to patient visits had to be reconfigured. Practice administrators had to manage a practice remotely. Doctors, nurses, and physician assistants had to treat patients via Zoom. All the while, providers had to comply with Medicare and HIPAA regulations.
As a result, many digital tools became further ingrained as part of the technology toolkit for doctors, hospitals, and other healthcare providers.
Staffing shortages, especially among nurses, constituted one of the biggest issues during the pandemic. Administrators could use data analytics dashboards to help understand their staffing and scheduling needs. They could use data to predict times of high demand and schedule accordingly. Each department could have its own data dashboard, and managers could use the information to get a high-level picture of operations.
Besides staffing and scheduling, data can provide insights into several different departments:
- Billing, reimbursement, and patient payments. Tracking billing, copays, insurance reimbursements, and accounts payable and receivable provides a financial picture.
- Supplies and inventory. The scarcity of personal protective equipment and other supply chain shortages made keeping track of inventory essential.
- Patient demographic and health data. Electronic health records (EHRs) and electronic medical records (EMRs) consist of patient demographic and health history data.
- Diagnosis and treatment. Tracking diagnosis, treatment, and appointment follow-up visits is an essential part of healthcare.
Chatbots and Automated Scheduling
The increase in healthcare demand put pressure on administrative staff, as well as doctors and nurses. Chatbots and automated scheduling technology helped ease some of that pressure. The benefits of these technologies include:
- Online scheduling. A patient can schedule an office visit online, answer a few questions about their symptoms, and use a calendar app to schedule the next available appointment.
- Online check-in. Patients can provide insurance and other information remotely, which allowed office staff to work remotely during the pandemic.
- More than just scheduling software, chatbots use artificial intelligence to guide patients through answering questions about symptoms, payment, and scheduling. This data can be added to a patient’s EHR and help provide insight into their condition.
Although doctors and other clinicians are wary of letting artificial intelligence (AI) diagnose patients, some research shows that AI is gaining in accuracy. Scientists “train” algorithms to recognize diseases such as cancer in mammograms and other imaging data. The more AI learns, the better these systems get. AI-supported diagnosis is likely to become a feature of the healthcare landscape of the future.
Perhaps the single biggest impact COVID-19 had on healthcare delivery was in telehealth. Prior to the pandemic, providers and patients alike had viewed telehealth with a great deal of skepticism. Telehealth had been initially proposed as a solution for rural communities and other areas with too few physicians. However, those areas also tend to have unreliable internet, which is critical to remote healthcare access. Despite the internet issues, COVID-19 illustrated that the proof of concept was sound.
When the pandemic hit, healthcare did a hard pivot. Telehealth and internet access became critical. While telehealth won’t replace in-person visits, its promise of improving access to care came closer to reality. Some of the changes include:
Reimbursement and Cost of Care
Pre-pandemic, Medicare and insurance companies might not have reimbursed doctors for a televisit. That changed during the pandemic when telehealth became the only way that some doctors would treat patients. Physicians who might have been reluctant to see patients remotely could now get paid for their work.
However, one of the original goals of telehealth was to lower the cost of healthcare, based on lower reimbursement rates. Health researchers are currently studying the cost of telehealth to get a clearer picture of whether it helps keep costs low.
Telehealth visits are convenient for doctors and patients. During the pandemic, and even as the pandemic receded, remote workers enjoyed the convenience of shifting from remote work to a doctor visit and back again. They could do that from their home office rather than driving to a doctor’s office. Telehealth also allows access to care for people who live in underserved areas, or healthcare provider shortage areas (HPSAs).
Telehealth is effective at reducing exposure to disease. Patients, doctors, nurses, and administrative staff could all be protected from COVID-19 with a telehealth visit. In a post-pandemic healthcare landscape, telehealth can limit exposure to other highly contagious diseases, such as the flu and strep.
3. The Healthcare Model Under Strain
Even before the pandemic, government officials, health industry researchers, and healthcare executives were concerned about the rising costs of healthcare and insurance premiums. Then COVID-19 caused a huge rise in the cost of care in a number of ways, putting a great deal of financial strain on hospitals. According to a study from Kaufman Hall, commissioned by the American Hospital Association (AHA), hospitals faced increased operating costs and loss of income due to the pandemic.
- COVID-19 treatment costs. According to healthcare research firm FAIR Health, which studies private healthcare claims, the average cost of a complex hospitalization for COVID-19 is $317,810. However, the average allowed amount (the most that insurance will pay) is $98,139.
- Loss of outpatient income. The AHA study estimated a $27 billion shortfall in the usual outpatient operations. People who would have had elective or even necessary surgeries canceled or delayed them due to the pandemic.
- Staffing shortages. The staffing shortage, most notable among nurses, resulted in higher human resources costs. Overtime and signing bonuses caused hospitals substantial financial stress.
Some of the ways the healthcare landscape has changed as the result of these factors include:
The Cost of Care
As shown by the lost outpatient income, a great number of Americans deferred healthcare in 2020 and 2021. This postponed healthcare could show up in the future as a missed cancer diagnosis, a heart attack, or another healthcare issue. A McKinsey study estimated that this deferred care could increase annual healthcare costs between $30 billion and $65 billion.
The traditional model for healthcare delivery in the U.S. is fee-for-service, in which providers are reimbursed for each office visit, diagnosis, and treatment. The shift to value-based care started before the pandemic but gained traction during it. The focus in value-based care is on outcomes and prevention as ways to improve the quality of healthcare and reduce costs. Experts expect this shift to accelerate following COVID-19.
State and federal governments lifted many regulations temporarily during the pandemic to quickly increase access to care. Telemedicine regulations were one such change. Medicare changes also impacted the healthcare landscape. While many of these changes are temporary, they’re designed to streamline care delivery. They range from allowing hospitals to treat patients in temporary areas to waiving requirements for surge conditions. As the pandemic wanes, the question of which regulations will be permanent will become clearer.
The high cost of prescription drugs has long been an issue for healthcare, insurance, and government officials. As healthcare costs and insurance premiums rise as a result of the pandemic, more people are struggling to pay for prescription medications. Medicare announced a large hike in prescription drug premiums, in part because of healthcare costs due to COVID-19.
4. Public Health
The COVID-19 pandemic shined a spotlight on public health in the U.S. and around the globe. Calls for community action — masks, hygiene, and social isolation — led to mixed results. However, the lessons of the pandemic can be used to strengthen public health, especially in rural regions and other underserved areas, which could help improve the overall health of the population and keep costs low.
Some public health initiatives include:
The vast sea of healthcare data can be used to analyze the health of a population and a community. Data analysts can identify healthcare issues and trends, as well as study the effectiveness of population health measures. Trained AI programs can comb through this big data to identify commonalities and help track infections, catching future outbreaks before they get out of control.
Educating the public on the benefits of public health can improve acceptance. Public service announcements can help reinforce good hygiene, good health practices, and other measures that support the health of common areas and the general population. Creating opportunities for community involvement can help prevent the rise of all kinds of infectious diseases.
Traditional Public Health
Traditional public health has always been concerned with dangerous diseases such as tuberculosis, measles, and hepatitis. Childhood vaccines, although rising in controversy, are another example of traditional public health. The coronavirus pandemic may support a resurgence of traditional public health policy.
The Changing Healthcare Landscape — Start Your Journey Here
COVID-19 will have a continued impact on the healthcare landscape for years to come. If you’re excited about the ways that healthcare management is meeting that challenge and you want to know more, explore Maryville University’s online Bachelor of Science in Healthcare Management. With coursework in public health, healthcare operations, and software and technology, this degree program is designed to give students a solid foundation in modern healthcare management.