Loss of hospital revenue from delayed and reprioritized elective surgeries is the number one concern among healthcare stakeholders, predicting it to have the greatest impact on the industry over the next few years.

That’s what one-third told Definitive Healthcare in a poll the information service provider conducted over the summer. From medical device manufacturers to providers and healthcare IT companies, respondents also expressed concerns over the postponement of essential care, backlogs and staffing shortages and the effects the COVID-19 pandemic is expected to have in 2020 and beyond.

“From closures to furloughs, it will take a number of years to recover from that loss of capacity,” Todd Bellemare, vice president of professional services for Definitive Healthcare, told HCB News. “Already, Definitive Healthcare's platform has tracked 75 healthcare facility closures, most of which are temporary due to the COVID-19 pandemic — but these could turn into permanent facility closures later if patients continue to avoid hospitals due to the virus. Rural hospitals have been hit hard as well. In addition to the trend of closures, the furloughs of healthcare providers will certainly impact the quality of care patients see over the next few years.”

Elective surgeries declined as much as 95% in certain areas of the country, with the Northeast and Western regions of the country seeing the highest impacts, according to Definitive Healthcare’s all-payer claims data.

Furloughs are expected to result in fewer specialists and less availability of support services that will impact the ability of patients to receive timely care. They are expected to lead to more ER visits, which can be an added drain on both time and revenue for providers. Rural hospitals are expected to take the brunt of the damage, with a large number already closing even before COVID. This will undermine care in underserved communities, which are composed of older individuals with higher rates of chronic conditions and a mix of insurance coverage rates.

Another concern is the postponement of essential care, with patients suffering from chronic diseases opting to avoid care out of fear of contracting COVID-19. This choice to not seek treatment could inadvertently worsen their condition and turn what otherwise might have been a preventable disease into one that requires a complex and costly procedure.

As much of the country’s patient population delayed care at approximately the same time, healthcare facilities now face massive backlogs that could take years to deplete, all while contending with even greater significant staffing shortages due to professional fatigue and COVID-19 infections among physicians and administration. If just one provider in a care facility contracts COVID-19, it can have grave consequences on workflow and delay needed attention to backlog demand, according to Definitive Healthcare.

The pandemic, however, has led to an increased reliance on telehealth, with medical claims dating indicating an increase by as much as 4000%. Fifty percent of healthcare leaders who participated in the poll agree that telehealth for routine care of chronic conditions was most likely to remain throughout 2020 and beyond, as it allows patients to receive essential care in a safe capacity and reduces unnecessary physical contact that increases the risk of viral infection. It also provides greater provider certainty that most patients in line for treatment are in need of critical in-person attention.

Respondents warn, however, that patients with chronic conditions should maintain regular preventative care visits with their care teams.

“As the country begins to reopen in certain areas, we anticipate that hospitals may be able to recover from significant financial losses through elective surgeries,” said Bellemare. “The hope here is that some of the pent-up demand for these surgeries will provide a bit of a bounce back. However, a note of caution is prudent — given that many of these procedures are expensive and commercial insurance is typically the source of those payments. With the added complexity of high unemployment and therefore lower insurance enrollment, that bounce back will be undermined to a degree that has yet to be fully felt.”