Ninety-seven percent of physician practices reported a drop in care volume by early April 2020 due to COVID-19, and that first wave of care deferrals offers lessons in managing the impacts of the current surge, according to a new report.
The Medical Group Management Association (MGMA) and Humana teamed up for a study on deferred care under the pandemic and found that safety was the top-cited reason for patients to skip care, with 87% saying so.
In addition, 9% said they deferred care due to job and/or insurance loss, and 4% said it was because of elective surgery deferrals or refusal to comply with mask mandates.
As a winter wave of COVID-19 continues to surge, the report says providers and health plans must map out and analyze these care gaps to ensure people are still receiving the services they need.
Mike Funk, vice president of Humana's office of the chief medical officer, told Fierce Healthcare that some of the key lessons to come out of the response to the first wave of deferrals include showcasing the value of telehealth, finding alternatives for preventive tests and the changing perceptions in how patients view public health efforts.
Telehealth use exploded under the pandemic and played a key role in filling many care gaps that would have otherwise been missed, Funk said.
"It really was a savior, if you will, for creating access for our members in this particular situation," he said. "I think the advancement of digital health and interoperability in general for the medical community will benefit from this particular pandemic."
However, telemedicine isn't for everyone, according to the report, and the barriers to its use are key lessons coming out of the early days of the pandemic. For one, while many senior patients proved to be savvy and comfortable with the technology, a number lacked internet access or tools necessary to access virtual visits.
Humana responded to this hurdle by teaming with Older Adults Technology Services (OATS), a New York-based organization that provides education to older adults on using tech that is also working to bring 1 million seniors online.
The insurer's philanthropic arm made a $3 million investment in OATS, Funk said.
"I do think there are bright spots [from the pandemic], and this work in terms of advancing technology for our senior population is a perfect example of that," he said.
Another area of concern, he said, is playing catch-up with missed preventive screenings and finding ways to ensure those tests are completed in alternative settings, including the home.
Humana sent out home test kits both for COVID-19 and for more routine tests, and it also found ways to address testing via telehealth, he said. In addition, the insurer worked with its front-line providers in value-based care relationships to ensure those tests were on the radar.
"That would probably be one example of what keeps me up at night," Funk said.
The report also notes that opening up the industry to greater innovation has increased consumerism in tandem, and primary care practices in particular must be prepared to adapt to the changing patient demands.
Doing so, according to the report, will help in boosting trust to bring those patients back to the office when the pandemic ends.
"Especially as patient consumerism continues to be a major force in healthcare, finding ways to meet the level of convenience that other industries provide every day to customers will nurture patients’ trust and restore visit and procedure volumes," the authors wrote.