Non-urgent medical services are on hold again in parts of Arizona, Florida, Mississippi and Texas, as hospitalizations due to COVID-19 surge. Providers in those states could lose additional revenue, and population health likely will suffer too.
Last Thursday, Gov. Greg Abbott of Texas expanded a ban on non-urgent services to 100 counties (Abbott had issued a similar ban for four of the state’s most populous counties in late June). The Mississippi State Department of Health issued an order postponing non-urgent services effective July 12 through 20. Some hospitals and health systems in Arizona and Florida have stopped non-urgent procedures on their own initiative.
Providers were already experiencing revenue shortfalls and a liquidity crisis from the first influx of COVID-19 patients and postponement of non-urgent services. Recent surges of additional COVID-19 patients and further postponement of non-urgent services will further weaken the financial position of providers. Hospitals in Miami, a new epicenter of the pandemic in recent weeks, averaged roughly one month of cash on hand before the pandemic hit, according to an HRI analysis of American Hospital Directory data.
Population health is also suffering directly and indirectly from the pandemic and postponement of non-urgent services. In a survey conducted by the Primary Care Collaborative in late June, 56% of primary care physicians noted exacerbation of health conditions due to lack of access during the pandemic, 44% reported health impacts from chronic care visits deferred, and 9% had patients die from lack of access to appropriate care.
Getting patients to return for care once non-urgent services can resume will be crucial for preventing poor health outcomes, avoiding much higher healthcare costs in the future, and saving financially vulnerable providers. As the US faces the likelihood of additional waves of COVID-19 and the continued suspension and resumption of non-urgent services, a strategy for communicating further closures and reopenings with patients will be crucial.
In a survey of 2,500 US consumers conducted in early May, HRI found that consumers who had delayed care early in the pandemic and not rescheduled it were looking to their doctor (30%), the CDC (19%) and to a lesser extent their local hospital or health system (8%) for reassurance before rescheduling care they had delayed. The 500 individuals surveyed in Arizona, Florida, Mississippi and Texas also ranked their doctor (25%), the CDC (25%) and to a lesser extent their local hospital or health system (9%) as their top sources of reassurance for returning for care.
Communication about the pandemic by providers was lacking early on. In a survey of 10,000 US consumers on the effects of the pandemic on health behavior conducted in early April, HRI found that only 12% of consumers were receiving health information about the pandemic from their primary care doctors and only 13% were getting it from their hospital or health system.
Communication by physicians, hospitals and health systems to patients about the protocols in place to prevent the spread of COVID-19 will be key to getting patients to return once non-urgent services can safely resume. This is especially true for patients with complex chronic conditions, who have been more likely to delay care and are more likely to suffer poor health outcomes as a result.
In early May, 25% of all consumers in Arizona, Florida, Mississippi and Texas said they had delayed some care since March 1 and not yet received it, on average delaying 65% of care. Of the 20% of consumers in those states with a complex chronic condition, nearly 40% delayed some care and had not received it as of early May, delaying 61% of care on average.