Pittsburgh Post-Gazette

Hospitals want you to know routine care is safe, despite virus MAR

Lack of procedures hurting bottom line

- By Kris B. Mamula

Your doctor can see you now. Really.

Patients have been slow to make appointmen­ts for routine medical screenings and operations following the shutdown of nonemergen­cy medical procedures due to the outbreak of COVID-19, despite the resumption of care and the assurances of hospital safety. The result is red ink splashed across hospital balance sheets nationwide because elective procedures are among the most lucrative for medical institutio­ns.

Now, hospital trade groups, insurers and others are turning up the feel-good messaging to encourage people to schedule colonoscop­ies, mammograms, and elective surgical procedures such as knee and hip joint replacemen­ts, despite COVID19.“The doors are open,” Healthcare Council of Western Pennsylvan­ia President A.J. Harper said. “Our members have demonstrat­ed that they follow universal precaution­s and welcome everybody back, but it’s a matter of the patients’ comfort level.”

Allegheny Health Network reported patient volume decreases ranging between 30% and 50% during the peak of the outbreak in Western Pennsylvan­ia, which started in March. Other health systems reported similar declines, leading the American Medical Associatio­n to estimate the national fourmonth impact of the disease at $212.6 billion — an average of $50.7 billion lost per month.

An alliance of 10 health care organizati­ons, including health insurer Humana, on July 7 launched Stop Medical Distancing, a national public service ad campaign with a simple message: Go ahead, make that appointmen­t. It’s safe to see your doctor again.

“We are seeing a troubling pattern that people are avoiding medical visits in fear of contractin­g COVID-19,” Humana Chief Medical Officer William Shrank said in a statement. “The intent of the campaign is to let people know that protecting yourself against getting this virus does not need to come at the expense of your health.”

A digital public safety announceme­nt by the Hospital and Healthsyst­em Associatio­n of Pennsylvan­ia, a Harrisburg trade group, has a similar

message. “While you played it safe, hospitals played it even safer,” a female narrator says warmly. “Contact your doctor and get your health back on track.”

The ads will appear on social media and other online sites, HAP spokeswoma­n Rachel Moore said.

Alisa Grishman is the kind of patient that doctors would like to reach. The 38year-old Uptown resident has multiple sclerosis, other autoimmune diseases and diabetes. That makes her fearful to leave her house during an outbreak of a highly infectious disease — especially to go to a hospital where she risks getting sicker.

“It’s been five months since I left my house,” said Ms. Grishman, who is covered by both Medicare and Medicaid. “I’m the benchmark for what vulnerable truly is.”

Ms. Grishman’s doctor canceled her recent routine appointmen­t, and she has turned to self-treatment for a medical problem since then rather than see a doctor, she said.

But “getting your health back on track” by rescheduli­ng some of those visits would help hospitals get back on track financiall­y.

Only 40% of 7,000 patients surveyed nationwide said they were likely to reschedule care within three months, according to a new study by Boston Consulting Group.

About 75% of health care providers say they have two months or less of cash on hand.

The pandemic is also changing the way medical care is provided as evidenced by the explosive growth in telehealth, the study found, while spotlighti­ng other issues in the nation’s health system, including questionin­g whether all of the medical care being provided pre-pandemic was necessary.

“Fear of COVID-19 is obviously a big factor in this shift [to telehealth], but the magnitude of the change also implies that a meaningful percentage of emergency department patients in the past did not actually need that level of care,” the Boston Consulting Group study found.

Emergency room care is often the most expensive in the hospital, experts say.

Financial pain is being felt by the 61 Western Pennsylvan­ia hospital members of the Warrendale-based hospital trade group, with 55% reporting a loss from operations and 82% with fewer admissions for the nine months ending March 31 when compared to a year ago.

Typically encompassi­ng the height of the flu season, the third quarter is often the best for hospitals financiall­y, council CFO Denis Lukes said.

“We would’ve expected to see improvemen­t,” he said. “Instead we see this substantia­l decline. It was huge in March, but the impact of April and May is going to be even greater.”

Patient comfort and fear of the virus may not be the only issue keeping people away.

An estimated 5.4 million American workers lost health insurance between February and May due to the COVID-19 outbreak, according to a new study by Families USA, a Washington D.C.-based nonprofit. That’s 40% more than during the recession of 2008, when 3.9 million adults lost coverage.

And things may not get better soon: An Urban Institute and Robert Wood Johnson Foundation study predicted that the number of people without employersp­onsored health insurance will climb to 10.1 million people by the end of 2020 as the result of the COVID-19 pandemic.

Still, doctors warn that putting off medical care could mean adverse health consequenc­es for the patient, especially when it comes to care for cancer and heart problems, said Atul Gupta, chief medical office and interventi­onal radiologis­t, Philips Image Guided Therapy Devices, which has corporate offices in Cambridge, Mass. During the heat of pandemic in the spring, deaths from heart disease and strokes spiked, Dr. Gupta said.

Warnings about the highly infectious disease coronaviru­s, which causes COVID-19, may have gone too far, he said, leading to the excess deaths of people who didn’t seek care when they needed it.

“Patients were afraid to come to the hospital for heart care, stroke and all the rest,” Dr. Gupta said. “The unintended consequenc­e is that we put a lot of fear into the people.”

 ?? Screengrab ?? A PSA by the Hospital and Healthcare Associatio­n of Pennsylvan­ia encourages people to make appointmen­ts with their doctors and visit hospitals for care.
Screengrab A PSA by the Hospital and Healthcare Associatio­n of Pennsylvan­ia encourages people to make appointmen­ts with their doctors and visit hospitals for care.

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