By Dr. Margaret Ferguson
Physicians are on the front lines of healthcare every day. When they speak out about what the American healthcare system needs to function properly, we should listen.
Recently, physician leaders of America's top medical groups and health systems commented on how what they've learned from COVID-19 can chart the path for healthcare delivery in the future. Speaking as part of the Council of Accountable Physician Practices (CAPP), a coalition of more than 30 integrated medical groups and health systems encompassing more than 85,000 physicians, here are their ten recommendations.
1. Our fragmented care delivery system cannot support major healthcare crises or the effective management of care even in normal times.
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Medical groups that made investments in care delivery improvements--such as population health management, telehealth, robust health IT to support care teams-- had the culture, leadership, and connectivity to quickly pivot during the pandemic. They ramped up the number of telehealth visits from single digits to thousands a day, identified and managed vulnerable at-risk patients, and set up command centers and crisis communication channels to deploy their resources. Providers who did not have this integrated foundation struggled with the rapid response needed for the crisis. Offering this type of integrated care to all Americans at all times, rather than the fragmented system we have now, could benefit everyone.
2. Telehealth is now an established care delivery option that overcomes safety and access barriers, therefore it should be paid for at the same level as in-person care.
Virtual visits are the house call of the present era. The waivers put in place to override restrictions on paying for both telephonic and video visits should be permanently adopted.
3. Care is moving home and should continue to do so.
The need to care for patients who were especially vulnerable to COVID-19 furthered the use of home-monitoring devices, video visits, and in-home care. Even hospital-in-the-home is getting a boost as CMS relaxes regulations to care for these patients in alternative locations to make more room for inpatient COVID stays. Digital advances in medical devices and communication will reduce the need for in-person monitoring and check-ups, and intelligent devices will help vulnerable patients and their families stay safe and healthy at home. As with telehealth, payment policies should be modified to cover this increasingly preferred way of healthcare delivery.