In the face of the global COVID-19 pandemic, healthcare systems across the US were advised to delay elective procedures to create capacity for the surge in COVID-19 patients, conserve personal protective equipment and to reduce transmission of the virus. Almost immediately, healthcare utilization dropped, and personal spending on healthcare services fell 38% in April 2020 compared to the prior year. Expenditures on physician and hospital services fell by more than 40% each.
What impact has this had on health? It’s well-established that care avoidance can lead to poor health outcomes in the long term, but a recent Kaiser Family Foundation poll suggests the negative impact of care avoidance over the last few months is being felt already. Nearly half (48%) of the adults polled say they, or someone in their household, have deferred care due to the COVID-19 pandemic, with 11% saying conditions worsened as a result of postponing care. This is especially concerning because employers can expect, according to Mercer actuaries, that 30%-50% of deferred medical consumption in 2020 to be eliminated entirely – meaning, many employees will not catch up on care they needed to stay healthy.
It’s understandable that employees would be hesitant to return to care, even as epidemiological curves flatten and healthcare facilities open their doors for maintenance care and elective procedures. That’s where employers can play an important role, by taking steps to support employees as they consider returning for care. And they can take the opportunity to build on one of the positives coming out of this experience – greater acceptance of virtual care, among both patients and providers.
Monitor and communicate local healthcare system status. Employees may have incorrect perceptions about the safety of seeking care from local providers. In fact, according to one epidemiologist and public health expert, “going to a doctor right now is one of the safest places people can be going because the screening protocols for staff, waiting rooms and getting into waiting rooms are so stringent everywhere.” That said, health system readiness is continually changing, so ongoing monitoring and communication of the status of outpatient and inpatient care, diagnostic services, COVID-19 testing capabilities will be essential. Employers should stay up to date with local authorities to monitor and communicate the efforts at the local community level.
Continue to promote digital health. Some employees will remain hesitant to enter the physical healthcare system due to fears of exposure or feeling their condition is not serious enough to warrant a physician’s time in the midst of a pandemic. Employers can provide and promote care pathways to meet employees and family members where they are in their care journey. As the adoption of telehealth by primary care providers grow, it’s becoming easier for employees to use their existing medical providers for virtual services -- which allows for continuity in care and often increases patient comfort. Employers should use this opportunity to re-educate, and communicate about appropriate care settings and alternatives to emergency department care.
Make care adherence easy. Employers should continue – or even expand upon – pandemic strategies already put in place to make compliance easier, such as extending prior authorizations for procedures, waiving or lowering cost-sharing for convenience care, encouraging mail-order pharmacy and maintenance medication refills and expanding access to services such as behavioral health support, flexible work schedules and caregiver support.
Explore or promote second opinion services. This is a great time for employees to reevaluate the care they were planning to receive but had to delay. Consider promoting or implementing second opinion services so employees can ensure that initial treatment plans are still appropriate.
Focus on employee well-being. Re-invent your employee well-being strategy for the new shape of work. As employers consider eliminating onsite well-being programs such as biometric screenings, flu shots and more, an alternative should be established for employees to get the same care in a safe and easy way.
Establish a communication plan. Think through how your organization will encourage employees to seek care.If you will communicate directly, ensure your communications are based on the latest CDC guidance for non-COVID care. Be clear and consistent, and have a plan to change your message if your community begins to see a resurgence in COVID-19 cases. But even if you choose to rely on your health plan and well-being partners to handle communications, it’s important to confirm that they will be providing communication to encourage members to seek care and to collaborate on the message.
Employers need to be nimble in supporting their population’s return to care: You need to have a plan, closely monitor the situation in different geographies, and adjust accordingly. But it’s well worth doing. Rather than simply looking at health plan utilization reports and wondering what the impact of delayed care will be next year, employers can take positive action now to safeguard employee health over the course of the pandemic, however long it may run.
Check out the replay of our recent webcast, Re-engaging Employees in Healthcare, to learn more.
Special thanks to Dr. Jeff Dobro, Sunit Patel, and Dr. David Zieg for contributing to this piece.