The Weekly Gist: The Cheesecake Crisis Edition

May we ask a favor?

As we look ahead to 2022, we’re considering a range of alternatives to make the Weekly Gist even more relevant and engaging for our readers. We’d appreciate it if you’d take five quick minutes to complete a brief survey to help guide our future work. Thanks so much!

A key insight or teaching point from our work with clients, illustrated in infographic form.

Despite telemedicine gains, many consumers prefer in-person visits

Although the pandemic has driven higher telemedicine usage, and a flood of investment in new virtual health startups, consumers seem to be largely set in their ways when it comes to seeking in-person care. When out-of-pocket costs are equal, a slight majority of consumers prefer to see a provider in person for nonemergency visits, according to a recent RAND survey. As shown in the graphic below, only a quarter of consumers would opt for virtual visits, if that were a cheaper option. On the other hand, nearly two thirds of consumers who indicated they’d prefer a video visit said they’d switch to in-person if it was cheaper, suggesting that consumers who favor virtual care are more price sensitive. These findings will vary depending on what kind of care a patient is seeking. According to a recent Rock Health report, consumers prefer virtual care for low-acuity needs, like colds or prescription refills. Surprisingly, although virtual care for behavioral health has skyrocketed during the pandemic, three-quarters of those surveyed said they’d prefer to access mental healthcare in person. But with the widespread lack of access to mental health professionals, virtual behavioral health solutions clearly fill a critical gap. Connecting virtual care with necessary next steps (diagnostics, follow-up visits, and the like) will be a future competitive differentiator. As the virtual care market continues to evolve, healthcare providers should look to create an integrated care experience that combines both virtual and in-person care offerings, creating omnichannel, personalized care solutions that match consumers to the right care setting to address their specific needs.

What we learned this week from our work in the real world.

It’s an unsafe time to be in the hospital

This week we caught up with the physician director of the emergency department at a large urban hospital. The hospital’s COVID admissions were up 60 percent compared to last month, but that was just one of his concerns. The emergency department is swamped every day, and staffing shortages are at critical levels. While this is nothing new, he said, it felt for the first time that the combination of unrelenting volume and short staffing were perceptibly affecting the quality of care. “It’s not just that we’re super busy and short staffed,” he shared, “it’s that there is no consistency in our staffing anymore.” When he would work a shift in the past, he was usually “on” with the same team of doctors, nurses, and techs—and those teams worked together like a well-oiled machine, anticipating each other’s needs, knowing how to expedite processes. Now a quarter of the nurses on some shifts come from travel agencies: “Thank God they’re here, but we’ve lost a lot of our speed and agility. I think it’s a very unsafe time to be in the hospital, not just for COVID, but for anything.”

This mix of challenges is almost certain to intensify over the next month, as Americans head out on holiday travel just as the Omicron variant is taking hold. We still don’t know how the severity of Omicron will compare to prior COVID waves. A recent article in The Atlantic summarized the potential impact well: “The variant’s threat is far greater at the societal level than at the personal one.” Those of us who are vaccinated and boosted will hopefully be spared severe disease, but given the variant’s sky-high transmissibility, hospitals could still find themselves overwhelmed, even if a smaller portion of patients require admission. The impact on staffing could be even more dire. In the weeks following Omicron’s emergence in South Africa, 20 percent of the country’s healthcare workers contracted COVID. US hospitals could find themselves in a similar position in early January, flooded with patients while experiencing a record number of staff under quarantine themselves. And we are starting from a position today where the system is already overwhelmed; in the words of one expert, “the level of care that we’ve come to expect in our hospitals no longer exists”. Anyone coming to the hospital, for any reason, may have their care adversely impacted. Managing this surge will require not just vaccines, but for Americans to push through pandemic fatigue and resume masking, distancing and other precautions—working for the collective good, not just our individual benefits.

All the headlines in healthcare policy, business, and more, in ten minutes or less every weekday morning.

On last Monday’s episode, we heard from Dr. David Nash, Dean Emeritus of the Jefferson College of Population Health, about the need to investigate whether the massive influx of spending on supplemental health insurance benefits focused on social problems, like isolation and transportation, is actually producing measurable returns.

Coming up this Monday, we’ll hear from Dr. Taki Michaelidis, Medical Director of UMass Memorial Health’s Hospital at Home Program. The Worcester, MA-based system has quickly scaled up its program, doubling capacity in just a few months.

[Subscribe on Apple, Spotify, Google, or wherever fine podcasts are available.]

And as ever, please let us know if we can be of assistance in your work. You’re making healthcare better—we want to help!

Happy Holidays!

Chas Roades
Co-Founder and CEO
chas@gisthealthcare.com

Lisa Bielamowicz, MD
Co-Founder and President
lisa@gisthealthcare.com