What is the Clinical impact of COVID-19?

Telehealth is on the rise among outpatient healthcare providers, but the number of patient visits is declining at a much more rapid rate during the coronavirus outbreak. While primary care practices are reducing staff or closely entirely to protect themselves and their patients from COVID-19, many are still seeing patients virtually.

Researchers recently analyzed data involving 50,000 providers, including independent single-provider practices, multispecialty groups, Federally Qualified Health Centers, and large health systems, and found that:

• The number of visits to ambulatory practices declined nearly 60 percent in mid-March and has remained low through mid-April.
• The decline in visits was largest among school-age children and older adults.
• The decline in visits was generally larger among surgical and procedural specialties and smaller in other specialties such as adult primary care, obstetrics/gynecology, oncology, and behavioral health.
• As the number of in-person visits dropped, telehealth visits increased. But the increase in telehealth visits only partially offset the drop in in-person visits.
• Nearly 30 percent of all visits at these ambulatory practices are now provided via telemedicine.

The study also found that, of all visits in a typical week before the pandemic, 47 percent were with primary care physicians (adult and pediatric) and 54 percent of visits were spread across more than 25 specialties.

Another study, focused on patient behavior during the COVID-19 pandemic, found that more than one in four patients (27 percent) said they had an elective surgery, appointment, or procedure delayed or canceled due to COVID-19. In addition, the Medical Group Management Association (MGMA) reported that practice revenue has declined by an average of 55 percent since the beginning of the coronavirus outbreak.

Elation Health supports primary care physicians by offering a COVID-19 Financial Guide, an overview of financial assistance available to independent practices during and after this difficult time.

Primary care physicians and other healthcare providers are adhering to recommendations set forth by the Centers for Medicare and Medicaid Services (CMS) and by the Centers for Disease Control and Prevention (CDC), including orders to stay at home and maintain social distancing. The CDC has recommended that physicians:

• Consider reaching out to patients who may be a higher risk of COVID-19-related complications such as the elderly, those with medical co-morbidities, and potentially other persons who are at higher risk for complications from respiratory diseases, to ensure adherence to current medications and therapeutic regimens, confirm they have sufficient medication refills, and provide instructions to notify their provider by phone if they become ill.
• Eliminate patient penalties for cancellations and missed appointments related to respiratory illness.

Regarding the telehealth option, the CDC suggests that:

• Healthcare facilities can increase the use of telephone management and other remote methods of triaging, assessing, and caring for all patients to decrease the volume of persons seeking care in facilities.
• If a formal telehealth system is not available, healthcare providers can still communicate with patients by telephone instead of in person visits, which will reduce the number of those who seek face-to-face care.

As states and local areas begin to ease COVID-19 restrictions, patients may desire to reschedule appointments. However, primary care physicians must continue to follow the guidance and restrictions for seeing patients in person again. Typically, communities must report declines in either the number of documented COVID-19 cases or positive tests in a 14-day period. States and regions must also meet other criteria in order to start reopening local economies.