While it is often said that every dark cloud has a silver lining, that particular aphorism is difficult to appreciate when one is standing under said dark cloud in a deluge.
And, by all accounts, the unfolding of the coronavirus outbreak in the U.S. and around the world has been a deluge of bad news and difficult-to-overcome challenges.
But as Fiserv’s Senior Vice President of Healthcare Solutions Colin Mellon noted during an On The Agenda Digital Roundtable conversation on the future of healthcare in the United States with Karen Webster; Buoy Health Vice President of Strategy Jason Lavender; Flywire Executive Vice President and General Manager of Healthcare John Talaga; and Amwell President of Clinical Solutions John Jesser, while there is no shortage of problems to solve about what’s going on today, a fair amount of remarkable stuff has happened in the last two weeks.
The American workforce shifted to telecommuting almost overnight, and regulators have found ways to shorten decision making that once took months and years into hours and days.
“The ability for American commerce and American business and American healthcare to be agile and embrace technology, it shows we can make fast changes to make things better,” Mellon said. “It’s just not very clear how well we can adapt and overcome.”
And while that rapid reset to thinking innovatively is present across all industries, it has been particularly on display in the world of healthcare in the last few weeks as a vertical that has lagged in terms of advancing innovation in both care delivery and payments operations has been forced to embrace the importance of transitioning from the physical to the digital world.
The situation is changing out there today, the panel agreed. But perhaps, more importantly, what is happening has the potential to change the direction of healthcare going forward — for the better.
Moderating The Situation On The Ground
Short of a vaccine, there is no silver bullet to stop the spread of COVID-19, the disease caused by the coronavirus, but there is a lot that can be done via digital tools that can slow the spread and keep the healthcare system from being overwhelmed.
That, Buoy’s Lavender said, starts with fixing the “front door” of a healthcare system with better triage and making sure patients are taking the right actions and going to the right places. Buoy Health, he noted, helps by connecting patients to accurate medical information and letting them know what to do next — whether that is staying home, seeking treatment digitally or heading to a physical treatment center.
Before COVID-19, Lavender noted, there were over 1 billion Google searches a day looking for medical advice. That number has spiked, and the goal is to make sure people are in touch with correct and actionable information.
“Our med team is working with the CDC [Centers for Disease Control and Prevention] regularly to make sure that we're providing digital guidance that is accurate and at scale,” he said. “And then we can hand them off to the right place, so that they're not just getting an answer and asking, ‘Now what?’ I think about 80 percent of our traffic over the last three weeks were people we could hand off to companies like Amwell and advise to stay at home to lighten the demand to make sure there are enough physicians available in hospitals.”
Amwell, which is a telehealth platform offering direct access to doctors and healthcare professionals, has also seen demand for its services spike over the last few weeks, Jesser noted. That spike has been on both sides of Amwell’s telehealth platform — patients looking for treatment, and physicians, particularly small practices — who until very recently had seen very little need to connect with this type of offering.
Literally, overnight, Jesser said, just about everyone now knows what “telehealth” is.
“Telehealth is really a great source for direct medical guidance, treatment, prescriptions ordering,” he said. “And even though there is no prescription for this necessarily, a doctor monitors who needs to stay home and drink fluids — and which patients look like they need to be in the ER so they can help make that happen. And now you're not having 500 people walk into the same ER at once saying, ‘I have a fever.’”
Flywire’s Talaga noted the crisis in action has also caused some rapid resetting of payments operations on the backend. Healthcare provider chief financial officers are also on the front lines of addressing the COVID-19 crisis. They were already grappling with how to create payment plans for consumers who need medical treatment but can’t cover the out of pocket costs to pay for it.
Exacerbating the problem now: Many healthcare providers’ patients may be facing a dangerously precarious financial situation over the next several months, Talaga said.
Flywire’s payment algorithm, he noted, allows for institutions to automatically adjust payments and plans in real time to align with consumers’ changing financial circumstances. That might mean suspending or modifying payment plans. Hospitals and care providers need to get paid now more than ever, so keeping revenue flowing while making workable arrangements for burdened consumers is critical.
But perhaps even more critical, he and the other panel participants said, is the pressure the current crisis has pushed into the healthcare ecosystem — and the potential for a better, more accessible and more efficient system going forward.
All panel participants noted that healthcare has not been an industry focused on digital innovation — either in terms of the provision of care or in paying for care. Digital health innovation has been around for a decade, Lavender and Jesser noted, but working with regulators, healthcare plans, the Center for Medicare and Medicaid Services (CMS), doctors and healthcare consumers themselves has been slow going. There has been a pervasive if-it-ain’t-broke-don’t-fix-it attitude.
And then COVID-19 came and exposed everything already broken and broke a few new things for good measure, like the economy and the supply chain. The world has responded to the pressure to fix it, panelists said. Adoption has spiked, officials have gotten a lot more open minded, and the entire vertical has learned nearly overnight that it can run fast if it has to.
That’s encouraging for the future of care because while the current spike will settle and “full speed ahead” is likely not the permanent attitude of the segment, they said, consumers at the end of the day drive the healthcare market like every other market in the world. When they experience better, they learn to want better, and insurance companies, providers and the CMS will ultimately follow where they lead.
“I really believe that with COVID-19, if we're open to learning from the crisis, it gives us the opportunity to change what has been a very laggard industry in terms of provision of care and administrative processes and takes us into a much better space,” Talaga said, noting that the time is now to purge the paper from healthcare and build modern, flexible systems ready to handle complicated surges like the one underway now.
While the future may not feel particularly bright today, he noted, especially for those working the front lines of the fight, medical care that is more understandable, more accessible and more affordable for patients is also care patients will seek more often.
Last year, he said, 25 percent of patients skipped care because they couldn't afford it. Next year, he noted, that number will likely be quite a bit lower, both because everyone on the planet just got a wake-up call about the importance of protecting their health, and because the tools and upgrades working in the field today will continue serving the same ends, even when the crisis is over.
Healthcare may be taking its medicine today — and a lot at once thanks to COVID-19 and the pressures it has created. But, the panel agreed, it will be healthier as a result for the rapid intervention.