Our Point of View
First confirmed US COVID-19 case in Washington State
WHO announces mysterious coronavirus-related pnuemonia
First record-setting Dow drop
CMS temporarily expands the use of telehealth
WHO declares COVID-19 a pandemic
CMS advises healthcare providers to limit "non-essential adult elective surgery and medical and surgical procedures"
Over 17,800 confirmed cases in NYC with 199 deaths; shortly after the city became an icon for how quickly the virus spreads and hospital bed shortages
President Trump signs CARES Act into law to support businesses, hospitals, and the rapidly growing number of unemployed Americans
- For the first time ever, there is payment parity between in-person visits and telehealth visits. Most providers had some form of telehealth platform in place pre-COVID, but they were not incentivized to rapidly adopt the technology. Providers continue to lobby to maintain payment parity, but payors haven’t made any promises.
- Approximately 1 out of 10 patients had used telehealth prior to this legislation. Providers had not only had their own steep learning curve to get their telehealth platforms running at a mass scale, but they had to educate their patients on the availability of their services and how to use the new platforms.
- This legislation furthered the strong wave of consumerism as patients get a taste of convivence by not having to leave their home for care and the cost for care is dramatically reduced or eliminated.
- Volumes drop instantly. “Health systems across the country experienced an average decline in patient volume of 56 percent between March 1, 2020, and April 15, 2020.”
- Provider financials take a hit on two fronts:
- Reduced revenue from high volume, high reimbursement business
- Increased expenses from PPE shortages and supply chain challenges
- Several capital projects are put on hold & reprioritized as clients try to figure out how the physical plant will be different going forward
- While health systems get some support, most argue it’s not enough to make up for revenue losses from elective surgeries. Providers now have less money for future investments in facilities, technology, research, etc. and must look for creative ways to reduce cost.
- Deferred maintenance of MEP and routine maintenance
- Shift non-clinical services out of the hospital and maximize I-2 space for diagnostic & treatment
- Work-force reductions in both non-clinical and clinical roles
- While health systems struggle to handle their massive platforms; agile competitors focused on telehealth and ambulatory care take off
- People are afraid to seek care not only out of fear of contracting the virus but because they’ve lost their jobs and health insurance. Temporary measures allow patients to get free COVID-19 diagnostic tests, but providers must educate consumers that this is an option.
- We anticipate that volumes will continue to be deflated through 2020 and telehealth will continue to rise. Providers will begin to reassess their physical footprint and look to consolidate space, let leases expire, and divert of antiquated buildings where appropriate.
- Discussions begin around the downstream impact of people avoiding care. Delayed preventative care will result in sicker patients (i.e. late-stage cancer diagnosis).
CDC recommends wearing face coverings
Gallup report finds that 1 out of every 7 people report they would avoid care for COVID-related symptoms due to concerns associated with the cost of care
$30B in funds become available for Medicare providers as part of the "CARES Provider Relief Fund"
HHS approves an additional $20B relief for Medicare providers
- CVS is leading the way for consumerism by providing services when patients need them, close to home, and at low costs.
- Healthcare providers are struggling to keep up with the demand for COVID-19 testing and non-traditional providers are filling the gaps. We anticipate that the CVS’s of the world will provide this type of rapid and/or self-serve testing for other diseases in the future. These non-traditional providers are rapidly capturing market share that health systems will have to fight for in the future.
- In the long-term, we project that CVS and other non-traditional providers like Amazon will dig into predictive analytics and begin partnering with companies like 23&Me for preventative medicine services.
CVS Health announces plans to open 1,000 self-swab COVID-19 drive-through testing sites
US COVID-19 deaths exceed 100,000
- AHA reports that providers are seeing a 19.5% decline in inpatient volume and 34.5% decline in outpatient volume relative to baseline levels. They further estimate that financial losses associated with volume declines and increased expenses associated with PPE will equate to at least $323.1 billion by the end of 2020.
Departments of health reported the highest number of new infections since the previous record set on April 25th
- Safety net hospital recipients can access between $5-$50M from the $10B Provider Relief Funds bucket
- Given their already razor-thin hospital margins, safety net hospitals face a higher risk of closure during the pandemic
- These hospitals treat the largest share of uninsured and Medicaid patients in their communities. This same population is also has disproportionately been impacted by the virus and have higher rates infection and hospital admission. The sudden closure of one these hospitals leads to delayed care and puts constraints on the remaining community hospitals.
HHS announces an additional $25B will be available to Medicaid and CHIP providers, safety-net hospitals and “hotspots”
US COVID-19 cases reach 2 million
Texas governor dials back and expands ban on elective medical procedures to free up resources for rising number of COVID-19 cases
US COVID-19 cases exceed 150,000 with approximately 1,000 deaths/day
Several CARES Act stimulus funds expire leaving unemployed Americans in fear about future unemployment benefits
-The big-box provider brought in industry professionals and celebrities to the table to talk about nutrition, chronic disease, and mental health. This instrumental move continues to root consumer expectations for free to low-cost care. Bringing in speakers their patients can relate to, Walmart is establishing a care delivery platform based on trust and understanding. While traditional healthcare providers have tried similar tactics in the past, the value proposition is limited. Unlike big-box retailers, health systems don’t have inventory to market and their downstream revenue from these events is backed on “potential” referrals. With no clear end in sight to the pandemic and reimbursement still structured in fee-for-service models, we anticipate continued slow growth in preventative medicine among traditional healthcare providers.
President Trump authorizes blood plasma as a treatment for COVID-19
Walmart kicks off its 3-day free virtual wellness fair
-Bill includes expanded telehealth coverage
CMS shares an advanced copy of the proposed 2021 Physician Fee schedule
President Trump authorizes blood plasma as a treatment for COVID-19Ministry of Health of the Russian Federation approves a coronavirus vaccine but skeptics raise concerns about the vaccines efficacy and safety given that it did not yet enter Phase 3
-Testing around 30 swabs per hour, the mobile rapid testing taps into unmet demand and provides simultaneous answers around current and/or previous COVID-19 infection.
-Continued research is being conducted around applying this technology for other diagnostic labs. Presumably successful, rapid results outside of traditional lab settings will be the wave of the future reducing the need for space in traditional lab settings and improving infection control in underserved areas with limited access to traditional labs.
Johnson & Johnson begins phase 3 vaccine trial
QIAGEN announces its plan to launch a rapid portable test that can detect SARS-CoV-2 antigens in people with active infections in less than 15 minutes
Kaiser Health study reports that an increase in approximately 3,000 daily positive COVID-19 cases is associated with schools reopening
-These stats show we’re not out of the woods yet.
-As the holiday season and flu season rapidly approach, people will be looking for access to rapid-test COVID-19 diagnostic solutions.
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