Is COVID-19 the impetus for a better U.S. health care system?

May 12, 2020

The COVID-19 crisis has laid bare these cracks in the U.S. health care system.

The fact that COVID-19 has hit vulnerable populations disproportionately, in both infection and mortality rates, has been lost on no one. But what does this mean to our healthcare system? Put bluntly, it means that until we solve the more fundamental disparities in healthcare, our past sins will continue to haunt us. 

This is devastating to these communities, to the lives interrupted tragically, but it also means that however much we try to kick the can down the road, the cost of poor patient engagement and management of chronic conditions continues to grow. 

The COVID-19 crisis has laid bare these cracks in the U.S. health care system, underscoring that the challenges of managing this acute crisis and the metabolic syndrome epidemic are completely intertwined.

The State of Value-Based Care after COVID-19 

For over a decade, healthcare policy has been shifting from a fee-for-service model of care to a value-based model. While most health experts agree that value-based care is inevitable, we’ve been stuck in a “two-canoe” problem, where providers want to cling to the predictable fee-for-service revenue streams while very gradually exploring new practices and technologies focused on driving better patient outcomes. 

Enter COVID-19. Predictability is out the window. Most health systems are ill-equipped to engage and monitor patients remotely. In the midst of this crisis, this has left many vulnerable populations with poorly managed chronic diseases at risk. We waited too long.

So, what will healthcare look like after COVID-19? Will this pandemic become the accelerator we desperately need for value-based care to take hold? 

Proponents of value-based care have long lamented the slow adoption of technology that enables virtualized care, particularly asynchronous approaches like remote monitoring, digital education, and chat-botting. Advocates have also argued for years that in order to achieve better patient outcomes, the US needs to put more resources towards primary care, restructuring the way primary care is delivered, and how primary care physicians (PCPs) are paid. These needs have never been clearer. 

Three Aspects of Care That Need a Remodel During and After COVID-19

As health systems keep one foot in the fee-for-service boat, they have been exploring how best to prepare for a shift to fully value-based care. With COVID-19 driving their renewed sense of urgency, it’s time to execute on these ideas: 

1. Utilize Telehealth Solutions to Monitor At-Risk Patients

There are several different types of telehealth, designed to help clinicians virtualize care. A video session with a patient is an important option for healthcare providers. It keeps exposure minimal and has proven an effective and convenient approach. However, it is important to note that a video call is simply a proxy for an in-clinic visit. Moving our care delivery approaches to a more continuous approach (to match the continuous nature of chronic conditions) is essential. Remote Patient Monitoring (RPM) is one way to do this. Simply put, RPM refers to the use of connected medical devices like glucometers, blood pressure cuffs, and scales to monitor how patients are doing outside of the times they are in the doctor’s office. In “normal” times, RPM helps health systems meet quality metrics, and prevent unnecessary ER visits and hospital admissions, while ensuring better patient outcomes. During COVID-19, RPM allows patients to still get the care they need while keeping them out of healthcare settings to limit potential exposure to the virus. 

Monitoring patients with chronic conditions like hypertension, high blood pressure, Type 2 diabetes and Obesity are common use-cases for RPM. Today this takes on a special importance, as more data is emerging that people with these conditions are at the greatest risk of developing severe symptoms of COVID-19. 

2. Money Talks: Restructure How Health Systems Profit

With many patients cancelling their in-person doctors’ appointments due to the pandemic, many family practices are struggling to stay afloat. Large health systems are also suffering from an almost complete stop in profitable elective procedures. Other essential procedures have been postponed. A legitimate fear coming out of this crisis is that chronic disease patients will continue to be deprioritized in the aftermath due to a rush for revenue. 

However, we believe that we can come out of this crisis stronger than ever. Copays on RPM have largely--at least temporarily--been suspended. The Centers for Medicare and Medicaid Services (CMS) has continued to reinforce the framework for RPM reimbursements. Primary care is beginning to see that virtualized care, in its many incarnations, can drive both revenue and better patient outcomes – even leading to new revenue streams. Look at gaps between those patients that regularly make appointments and those that really need care. RPM may work in these cases, and is reimbursable to as much as $120 per patient, per month on average. By virtualizing care, providers can engage high-risk populations more effectively throughout their lifecycle, treat remotely where appropriate, and bring patients in for clinical appointments and procedures when necessary. This has the potential for creating a new level of patient loyalty.  

3. Don’t Shuffle the Deck, Scale the Team with Technology

There are a myriad of reasons that have caused pause in adopting new technology -- overworked IT teams and disrupted clinical workflows, for example. But ROI should not be on the list. Technology that integrates seamlessly and allows clinical staff members to view, communicate with, educate, and monitor more patients, while enabling them to focus on the patients in need of intervention, can pay for itself easily, while also improving staff morale and increasing patient loyalty.

Implementing new technology at health systems can be daunting, but in order to avoid current challenges, we must make changes to the current healthcare system. Let’s embrace what our clinical teams are going through now. Let’s think about how to avoid another crisis like this. Let’s focus on the core disparities in our healthcare systems. These challenges can be addressed and solved, but they require a new way of looking at care delivery.

About the Author

Joshua Claman is the CEO of Rimidi, a cloud-based software platform that enables personalized management of health conditions across populations. He has over 25 years leading technology businesses in Asia, Europe and the Americas. His industry experiences span his time in Dell in several senior executive positions, including the founding and development of Dell’s European Healthcare business, to his role as president of ReachLocal, one of the largest advertising technology companies in the U.S., and serving as the chief business officer of Stratasys, a leader in 3D printing in the medical field. Josh is a strong advocate for the promise of technology.