COVID-19 will leave a permanent mark on health care

By Alex Branch

 B3f0263.jpg

The COVID-19 pandemic could cause lasting fundamental changes to the U.S. health care system, including how and where patients receive care, said an HSC Fort Worth expert in Health Behavior and Health Systems.

“Unlike some countries, we have not experienced a hard reset of our healthcare system,” said Thaddeus Miller, PhD, Associate Professor in the School of Public Health. “When that happens, it’s usually only because you are forced to do it. This may force us to do it.”

The final result of those changes is still as uncertain as the novel coronavirus itself. Health providers, hospitals, insurers and health regulators are scrambling to navigate the crisis.

Small practices already feel the economic impact of patients no longer coming in for routine seasonal illnesses. Medicaid will likely soon feel the strain of millions of Americans losing health benefits as they lose their jobs. Health services are being provided in nontraditional settings like drive-through test sites.

Meanwhile, long-standing rules have changed to give the healthcare system flexibility, allowing hospitals to provide care outside its walls, letting resident doctors perform more duties and eliminating some paperwork requirements so providers can spend more time with patients.

“The health care industry, like any other industry, is adapting to COVID-19,” Dr. Miller said. “Just like in other industries, some of the effects and innovations will probably become permanent.”

Virtual-care services – providers and patients interacting by webcam, for example – has flourished as patients are encouraged to stay home and not visit doctor’s offices. One previous drawback to virtual care was that it was often more difficult for providers to get reimbursed for the care they provide.

“Once people get used to something, it’s hard to take it away,” Dr. Miller said. “Some changes to reimbursements have already been for virtual care due to COVID-19, but making it work long-term for the patient and provider will probably be necessary.”

Changes in patient behavior, however, could alter the landscape of smaller, physician-owned practices. Without patients coming in for non-emergent illnesses and with prohibitions on many elective procedures, business has plummeted.

“A small physician’s office operates essentially like any small business – last month’s appointments are this month’s cash flow,” Dr. Miller said. “Patients are no longer coming in to be seen for routine illnesses. If you are a big practice with deep pockets, you’ll make it. A small practice might not.”

Changes in behavioral determinants for health could make us better off from a population health perspective. People eating healthy home-cooked meals, taking family walks and commuting less during social distancing might realize they feel great.

“My family, for example, hasn’t darkened the door of a fast food restaurant in weeks,” Dr. Miller said. “We’re cooking at home and taking walks together. Most of us are probably healthier now than we were two or three weeks ago.”

The long-term health repercussions for survivors of COVID-19 are not yet known but could have a significant impact on the health care system. Studies of survivors of the SARS pandemic, which infected about 8,000 people in 2002 and 2003 and shares similarities with the novel coronavirus behind COVID-19, found that many of them experienced long-term health effects.

There are already almost 1 million confirmed cases of COVID-19 worldwide and that figure will continue to soar. If the disease leaves survivors with long-term respiratory problems or other ill effects, the healthcare system would have to adjust for that.

“I was telling my 17-year-old daughter recently that she will remember a ‘before’ COVID-19 and an ‘after” COVID-19,” Dr. Miller said. “Good or bad, changes are coming. Healthcare is no different.”

 

Recent News

Screenshot 2024 06 20 At 3.45.01 pm
  • Our People
|Jun 20, 2024

From sacrifice to success: a journey through physical therapy school

Ancelmo Mojarro came to Fort Worth to study. The Tyler native knew he wanted to be a physical therapist early on his undergraduate days. He embarked on his path to physical therapy a decade ago, inspired by a friend's suggestion amidst his quest to find his calling in the medical field. “I starte...
Garciarosanski
  • Our People
|Jun 20, 2024

HSC pro bono physical therapy program offers hope

For 70-year-old Beverly Rozanski, the journey to improved health has been long and challenging. Raised in Michigan, Rozanski spent her childhood and early adult years struggling with physical challenges that made even the simplest tasks seem insurmountable. However, her discovery of a pro bono p...
Mills John
  • Our People
|Jun 20, 2024

Team of experts from HSC and TCOM develop a national position statement for NCCHC on care for aging patients in correctional facilities

Addressing an overlooked and sometimes neglected patient population, a group of experts from The University of North Texas Health Science Center at Fort Worth partnered with the National Commission on Correctional Health Care to write a “Care for Aging Patients in the Correctional Setting” posit...
Jennifer Fix 2 Purple
  • Education
|Jun 18, 2024

Pharmacy technician shortage driving force behind new, online prep course

A self-paced, online Pharmacy Technician Preparation Course is now being offered through The University of North Texas Health Science Center at Fort Worth as a way to help combat the shortage of pharmacy technicians at hospitals, health systems and retail pharmacies. Recognized by the Pharmacy Tech...