For months, public health experts have warned of potentially catastrophic fall and winter seasons, as cooler temperatures across much of the nation are expected to usher in a second wave of the coronavirus — just in time for flu season. Indeed, on the date of writing, the U.S. had hit its highest record for new COVID-19 cases for the third consecutive day.
Happening in tandem is yet another worrying trend — a state budget crisis akin to that of the Great Recession. Recent projections have begun to quantify the pandemic’s economic impact, with the Center on Budget and Policy Priorities (CBPP) reporting precipitous declines in revenue alongside rising costs, and some states already cutting funding, including for critical services, such as behavioral healthcare. As the COVID-19 crisis persists, the full extent of state revenue losses remains largely uncertain. According to CBPP, this likely means that policymakers are merely staving off larger cuts until they have a clearer picture of the scale of anticipated revenue drops.
To some degree, these cuts may be inevitable, though nonetheless harmful to many of the programs and services that are most critical during a health and economic crisis. They are also intermediate solutions to a much more complex issue. There is perhaps no better time than at this point of inflection to pursue measures that fundamentally improve the health of populations, reduce healthcare spending and are sustainable over the long term.
Population Health Management Strategies
Population health management simultaneously reduces costs, improves health outcomes and, relevant to the crisis at hand, reduces the burden on the healthcare system. Understanding where people are in their healthcare journey and meeting them there with personalized communications, targeted interventions and ongoing care management helps to avoid serious and costly healthcare issues across a broad range of indications.
It takes a concerted effort to manage the health of populations, spanning policymakers, multiple government agencies, payers, providers and even patients or healthcare consumers themselves. Below are some critical actions that can be applied at both a program and policy level to better manage population health:
- Promoting healthcare consumerism and engagement. Ensure the use of personalized, multi-channel outreach — SMS, email and Interactive Voice Response — to keep healthcare consumers connected through the current pandemic and in its aftermath. This may include:
- Educating patients on the availability of telehealth benefits.
- Encouraging your Children’s Health Insurance Program patients to receive recommended well visits.
- Urging your state employees to get the flu vaccine.
- Providing your most fragile and chronically ill Medicaid members with information on how best to manage their particular illness or illnesses.
- Permanently enabling and maximizing telehealth. Telehealth found its heyday during the pandemic and has proven itself a viable path to care in a socially distanced world. However, telehealth can also be helpful in overcoming some long-standing barriers to care, such as transportation issues, limited healthcare availability in rural areas, etc. To permanently enable telehealth, establish structural parameters around these services, such as permissible modalities, reimbursement rates and patient access rules, to enable telehealth access through and beyond the COVID-19 emergency period. To maximize its use, conduct concerted education and outreach regarding patients’ benefits for, and instructions on how to actually use, telehealth.
- Leveraging analytics. Healthcare analytics have come a long way. With the right data sets and analytics tools, we can better manage not only an individual’s health, but also the health of cohorts and populations. It is important to equip healthcare programs to maximize use of healthcare data with predictive and retrospective analytics. Leverage federal funding, grants and private sector best practices to adopt advanced analytics tools and apply them to better manage the coronavirus as well as the broader scope of chronic and costly health conditions.
- Addressing barriers to engagement. Reevaluate rules and regulations governing healthcare data sharing and telecommunications in the context of the COVID-19 crisis. Adjust policies as feasible and necessary to remove barriers to engagement — for example, advocating for a permanent healthcare exemption to the Federal Communications Commission’s Telephone Consumer Privacy Act and ensuring efforts to deflect robocalls do not inadvertently impede legitimate, wanted healthcare communications.
Focusing on Sustainability
Without question, healthcare stakeholders from all areas of the industry have and will continue to face difficult decisions in light of the COVID-19 pandemic. Population health management, though not an end-all solution to the acute crisis at hand, can help to address many of the systemic barriers preventing people from living healthy lives and driving unsustainable healthcare spending. Implementing these strategies today will serve to create a stronger safety net for the duration of the pandemic and the economic challenges that follow.
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