The COVID-19 pandemic has dramatically changed the lives and livelihoods of millions of Americans. In fewer than 100 days, the virus has killed tens of thousands of our fellow citizens while dealing immeasurable damage to the global economy. At the same time, there is another public health threat brewing that, without substantive policy changes, will deal an irrevocable blow to countless hospitals and healthcare providers.
So-called elective procedures were largely shut down in March and April as healthcare providers focused precious resources on treating COVID-19 patients.
To protect patients, specialty practices actively kept patients without active diseases away from their clinics. While the loosening of regulations around telemedicine helped, many healthcare procedures have been seriously curtailed as evidenced by recent data showing routine cancer screenings down by 94% and medical imaging procedures reduced by 50%.
While the near-total stoppage of healthcare is heaping unsustainable financial strain on providers across the nation, it also means that countless patients are not getting medical imaging exams when they need them. Delays in diagnosis and treatment could worsen health outcomes and will probably cause higher spending later. For example, diagnosing and treating breast cancer at its early stages has proven to lead to more positive overall outcomes and significantly reduced costs. Women that do not know they have breast cancer will face a more challenging road to recovery. And it will cost more for all participants—patients, payers and employers.
While economists debate the shape of our economy’s reopening, we will need a "v-curve" for nonemergent and preventive medicine as soon as possible. Screenings, exams and procedures need to get back on track to prevent excessive downstream mortality and monetary costs.
Spurring a quick healthcare recovery also requires Congress and other government officials to recognize the importance of payment policies that ensure physician practices and hospitals can effectively treat more patients even as they meet COVID-19-related challenges. Either/or is no choice at all.
To begin, federal officials must return to medicine's old axiom—do no harm—by suspending evaluation and management budget neutrality requirements in Medicare's physician fee schedule (PFS) final rule. Slated to go into effect in January 2021, this rule would impose deep reimbursement cuts across a range of specialty providers that are already under unprecedented financial strain. The PFS final rule was also devised based on pre-pandemic assumptions about our healthcare landscape. Applying an antiquated policy that will potentially deal a fatal blow to countless healthcare providers is counterproductive—especially in the context of a public health emergency.
Next, Congress must lead to ensure innovative, precision diagnostic drugs are widely available to patients who have delayed vital medical screenings throughout the pandemic. This means providing higher reimbursement for diagnostic radiopharmaceuticals, which have proven effective in detecting cancers and cardiovascular disease—conditions that will likely rise in prevalence if Americans avoid healthcare facilities unless vitally necessary. By including the Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 (H.R. 3722) in the next round of COVID-19 relief, lawmakers can ensure that providers are able to screen more patients and play catch-up on diseases that have not been detected due to COVID-19-related shutdowns.
As federal regulators and legislators work on policy solutions, physician practices and hospitals are doing their part to shore up our healthcare infrastructure to combat COVID-19.
Infection control in healthcare settings has always been of the utmost importance, but COVID-19 has forced all providers to go to even greater lengths by investing in new infection control procedures and training to ensure facilities are virus-free. Providers also must allow for more time between patient visits to properly sterilize equipment and rooms. Here, too, federal help will be needed. This enormous effort on the part of providers to strengthen infection control measures requires Congress and the Medicare program to put in place payment policies that recognize the new reality and provide financial and regulatory support.
Consumers want peace of mind so they can visit their healthcare provider when needed and without undue concern about COVID-19. As Altarum economist Ani Turner recently said: "Of all the places people want to come back to quickly, a health care setting is probably not at the top of the list." But if someone needs medical care, getting it should not cause any additional anxiety about personal safety.
Peace of mind is being addressed. For instance, adoption of standards advanced by the Consortium for Universal Healthcare Credentialing, of which the Medical Imaging Technology Alliance is a member, helps ensure the safe and efficient flow of products and services into hospitals and provider clinics. Also, hospitals and clinics continue to impose strict screening and visitation limitations and equipment and rooms in hospitals and clinics are being sterilized according to highest public health guidelines. These measures, which are the right thing to do, have caused an increased strain on resources for healthcare facilities.
Healthcare delivery may never be what it was before March 2020. But through collaboration among providers, payers and manufacturers, a new normal will develop—one that keeps patients first but also rapidly restarts our healthcare economy.
Dennis Durmis is senior vice president of Bayer Radiology for the Americas region and serves as chair of the Medical Imaging Technology Alliance board of directors.