Quincy, Ill.-based Blessing Health System has rebooked about 850 of its postponed non-urgent surgeries, which puts the rural provider on a tentative path to break even by the end of its fiscal year on Sept. 30.
While COVID-19 didn't hit the community as hard as expected, Blessing is prepared for a potential second wave this winter, said Maureen Kahn, CEO of the health system.
It added nine negative-pressure rooms adjacent to its 345-bed hospital's emergency department, converted its medical-surgical, pediatrics and maternity units to negative-pressure and intensive-care rooms, transitioned its operating rooms to intubation units, and has built up its supply of personal protective equipment.
While the temporary regulatory changes involving telehealth have been a big help, virtual and remote care has only partially offset the losses from its highest revenue generator—surgeries, Kahn said.
"As states start opening up and people are getting more comfortable, taking vacations and taking their masks off, we are watching some of those states increase in not only COVID-19 cases but hospitalizations," she said. "That gets us a little bit concerned."
Around 70% of more than 100 health system executives surveyed in mid-June said their main concern post-pandemic is replacing lost patient volume and revenue, according to a new poll from healthcare consultancy Advis. Hence, a similar share said their focus is on marketing, education and patient outreach to restore patient volume.
Providers are concerned about patients' lingering health issues that could get worse without treatment, but they are also worried about the lasting impacts of eliminating their main revenue source, said Lyndean Brick, CEO of Advis.
Approximately three-quarters of respondents expect that physician practices and hospitals will turn to mergers and acquisitions over the next year as a result of the COVID-19 financial crunch. Providers are also exploring cost cutting both with and without staff reductions (albeit a much smaller share for the former), developing new revenue streams and entering new partnerships to boost patient volume, improve efficiency and streamline costs.
"How we did this—unilaterally shutting down elective surgeries across the country—made no sense," said Brick, noting that 62% of respondents said they don't support cancellation of non-urgent surgeries in the event of a second wave. "We need a much more informed approach to this."
Aside from recouping patient volume and revenue, healthcare executives are most concerned about staff burnout, a potential second COVID-19 wave in fall or winter, and ongoing inflated costs or shortages of medical supplies.
Another recent survey revealed that more than 80% of primary-care clinicians' stress levels are at an all-time high and only 1 in 5 feels they have the resources or support needed to cope with COVID-19-related burnout, according to a poll from the Larry A. Green Center, the Primary Care Collaborative and 3rd Conversation.
Blessing, for instance, added 24-hour telehealth counseling services for its staff and families as well as group therapy sessions, Kahn said.
"Our staff went through a lot," she said. "When the adrenaline crashes, we might miss some signs and symptoms of stress."
Over the long term, executives are most hopeful that the broadening of billable telehealth services and easing of related regulations will stick. More than two-thirds also hope that CMS eliminates the "three-day rule" that stipulates Medicare beneficiaries stay in an inpatient hospital for three consecutive days to be eligible for Medicare-reimbursed skilled-nursing and rehabilitative care.
The pandemic should prompt healthcare providers to revisit their efforts to address social issues as they relate to an individual's health, Brick said.
Much of healthcare has yet to fully acknowledge how racial discrimination and bias have shaped the structures and policies that systemically disadvantage minority communities, experts said.
As a result of the disproportionate impact the pandemic has had on communities of color, around two-thirds of executives said they reexamined existing policies, protocols and practices to boost access. The next most common efforts were related to advocacy efforts to promote funding and programs benefiting communities of color as well as providing free testing for communities of color.
Executives wrote to Advis that they have hired diversity officers, started new programs, launched scholarship funds and opened new facilities in areas hardest hit by COVID-19, Brick said.
"These are examples of people doing purposeful activity to respond to the disparities in healthcare that have become so very evident because of this disease," said Brick, adding that the limited reimbursement for population health services must change. "When you take the Black Lives Matter movement and couple that with the pandemic, I think some of the positive outcomes will be looking at the funding for the social determinants of health."