The COVID-19 pandemic has forever altered a lot about the health care system since it first arrived in March 2020 – telemedicine, behavioral health, insurance coverage, vaccines and even waiting rooms.
Panelists who took part in the second discussion at the virtual PBN Health Care Summit on April 8 touched upon the effects that the global crisis has had on health care and what people can expect in the future as a result.
Dr. Michael Bradley, CEO and president of Orthopedics Rhode Island Inc., said his company last month opened a $33 million facility in Warwick that will allow for exams, therapy, X-rays and surgical procedures.
Ortho Rhode Island spent time during the pandemic reevaluating the patient experience with an eye toward elminiating the need for waiting rooms.
“I don’t ever want to go back to sitting and waiting an hour before you get called into a doctor’s office; it just seems archaic,” Bradley said.
Panelists also discussed what steps Rhode Island can take toward fixing problems that have been highlighted by the crisis, such as the need for health equity and increased affordability for services.
In addition to Bradley, panelists included R.I. Health Insurance Commissioner Patrick Tigue; Dr. Claire Levesque, Tufts Health Plan chief medical officer for commercial products; and Dr. Matt Collins, chief medical officer and executive vice president of Blue Cross & Blue Shield of Rhode Island.
Tigue said the priorities of increasing affordability should be to move to value-based payment plans rather than fee-for-service plans, focus on community investments outside of health to ensure that initiatives such as housing and transportation are sufficiently prioritized, and to take action on decreasing prescription drug prices.
‘There’s so much innovation in primary care right now.’
DR. MATT COLLINS, Blue Cross & Blue Shield of Rhode Island chief medical officer and executive vice president
With a drop in volume of many health services during the pandemic, medical providers suffered financially; having a system that incentivizes quality and serving patients well, Tigue said, will both help health care companies financially and assist public health.
While the COVID-19 vaccine is important, Levesque said people need to continue to seek vaccines for other illnesses.
She noted that Tufts gave a $50 incentive to parents who brought their children to a pediatrician for a flu vaccine. “We did that because we wanted to get them back into the pediatrician and to get all their catch-up vaccines,” she said. “So people were not getting their children in for the measles vaccine. We don’t want to follow up a COVID pandemic with a measles pandemic.”
Among the lessons learned from the pandemic was the benefits of telehealth in behavioral health. Tigue said it broke down some of the concerns about receiving behavioral health services. “I think many consumers feel more comfortable availing themselves of those services from the comfort and security of their own home,” Tigue said. “I think it’s a really effective strategy to potentially reduce stigma for people seeking services for that care.”
Levesque cautioned that it won’t be a good fit for every patient in the future.
“One example I’ll give is a 16-year-old who’s seeing a therapist and really doesn’t want to do it from home because they don’t have a private space for that,” Leveque said. “So they’d rather go into the office so they can have the door closed and their parents don’t hear what’s happening. So how do we ensure that the new vision of behavioral health is designed so that everybody can get care in the space that’s best for them?”
As technology shifts, so too will how doctors and providers think of primary care.
While some industry observers have said there’s a possibility that primary care physicians and standalone practices will vanish, the panelists said that they will evolve instead.
“There’s so much innovation in primary care right now because people need a first point of contact, continuous comprehensive care,” Collins said. “And there’s no person better to do that than the primary care provider.”
Both Collins and Levesque touched on how the insurers were working to reduce racial barriers to health equity.
“We have to be able to measure those disparities, and I would say we generally don’t do a good job in the health care world of identifying that,” Collins said.
Levesque said Tufts had put together a group to work on health equity. They’ve worked on it in two ways: looking inward to remove unconscious bias, such as using gender-neutral language in materials distributed to their members, and working with consultants to examine Tufts’ policies.
Collins also detailed the initial decision by Blue Cross & Blue Shield to no longer waive cost-share or out-of-pocket treatment for COVID-19 as of April 1. It was later reversed. Collins said the insurer originally had decided to end the waivers because of forecasts about the spread of the virus.
“We picked March 31, and we would revert to what the original plan was, which was some out-of-pocket cost-sharing,” he said. When the insurer contacted customers who buy from Blue Cross and got negative feedback, it reversed the decision and extended the waiving of costs.
