Healthcare leaders across the country are in pure survival mode right now. It's hard to think beyond the next few weeks as we scramble to adapt to the new world of COVID-19 and brace for the impact on our hospitals and providers.
At the same time, though, it's becoming clear that the effects of the pandemic are going to be felt long after this storm has passed.
At the Medical Group Management Association, we ran a quick survey of our governing affairs council to understand the main concerns of physician practices, hospitals and healthcare systems. Many of the responses wouldn't surprise anyone who's been following the reporting on our healthcare system's under-preparedness for the pandemic.
The lack of personal protective equipment like masks and gowns is a huge issue—one provider shared that he had to get the necessary gear from a combination of Home Depot, his dentist and patient donations. Some smaller practices have only a handful of N95 masks and no idea where to get more.
A related dawning realization is that our own colleagues are at severe risk of sickness and even death. Some leaders told us that a third of their staff are already out sick with symptoms. Sobering figures from Italy and Spain show that around 9% and 13%, respectively, of those who died from the virus were healthcare workers. Statistically, about 25% of our physicians are in the high-risk age category, and it's also become clear that COVID-19 is not exclusively an illness for those over 65.
If we do lose colleagues, it will have a prolonged psychological impact on the sector. I would expect it to increase the high stress and burnout rate among physicians, as they grieve while dealing with the impact of provider shortages. Let's remember that physicians already commit suicide at more than double the rate of the general population.
The biggest long-term concern we're hearing, however, is about the financial impact of the crisis, and how it may be exacerbated by a forced acceleration in the shift to value-based care.
Many healthcare leaders are worried that the financial assistance that practices, hospitals and systems will receive from the Coronavirus Aid, Relief, and Economic Security (CARES) Act is going to come with strings attached. The CMS and HHS have been moving toward value-based care for some time and their philosophy is likely to be "don't let a good crisis go to waste."
Over the long term, we absolutely need to move to a system based more on preventive care and true public health. But this transition requires complex, far-reaching changes in systems and personnel that are usually phased in over years. The concern is that these changes are going to be demanded at a time when hospitals and healthcare systems are financially and psychologically depleted. The recovery is likely to be hard enough without the need to rush the transition to entirely new ways of delivering and measuring services.
The federal government may also view lower healthcare payments as one way to recoup a chunk of the roughly $2 trillion it's spending to rescue the economy. However, hospitals and medical practices will be navigating the financial fallout of COVID-19 every bit as much as other major industries in our economy, and in some ways even more. A long-term view needs to include an awareness that a double financial hit may mean the loss of more critical healthcare sites.
As we head into what is sure to be an overwhelming and stressful period, a lot of uncertainty remains about the long-term outlook. But based on this early feedback from healthcare leaders, we're hearing a clear concern that the sector will be paying the financial and emotional costs of the pandemic for years to come.