The story of a summer season defined by the COVID-19 Delta variant is a tragic one for many hospitals across the United States in 2021:
- Intensive care units (ICUs) pushed beyond capacity by a wave of mostly unvaccinated COVID-19 patients shut down elective procedures and forced reassessment of “crisis standards of care” triage protocols and decisions in some states.
- Two public health districts in North Idaho were authorized to use crisis guidelines for rationing ventilators, ICU beds and staff time amid the public health emergency.
But in the outpatient care world, the effects of a resurgent pandemic look different depending on the specialty.
A Sept. 7, 2021, MGMA Stat poll asked medical practices how their patient volumes were affected by the Delta variant spike in the summer months. The results found a split between those whose patient volumes increased (42%) and those that stayed the same (43%), while only 15% reported patient volume decreases (15%). The poll had 751 applicable responses.
Practices that saw patient volumes ebb reported an average decrease of 17% during the summer compared to spring 2021 levels.
Results were largely driven based on specialty:
- Several respondents from emergency medicine noted they had patient volume increases driven by the increased number of COVID-19 cases.
- Respondents in pediatrics practices noted a large uptick in patient volumes, though more likely due to seasonal shifts to account for sports physicals and well visits prior to the start of the school year.
- Several of the respondents that reported decreased patient volumes were from specialties in which in-person care is dominant and there are fewer opportunities for telehealth visits (e.g., OB/GYN, surgical specialties).
These results follow a June 1 MGMA Stat poll that found almost half (49%) of healthcare leaders said their doctors worked more hours on average in the first half of 2021 versus 2020, and another 25% reported the hours worked were the same as in 2020.
This upward trend for patient volumes in medical practices follows sharp declines in 2020 utilization in the early months of the pandemic. A Peterson-KFF Health System Tracker analysis of Bureau of Economic Analysis (BEA) data recently found that overall health services spending in June 2021 was 7.1% below prior years' trends.
Beyond addressing the pent-up demand of patients who may have delayed or deferred care in the past year and a half, these visit and procedure volumes also continue to be impacted by a still-tight labor market after a rash of unexpected physician retirements, difficulty recruiting for clinical staff and a flurry of bonuses and other incentives attracting top talent elsewhere.
What’s next in pandemic fight?
While there have been headaches about the emergence of the B.1.621 (“Mu”) as a variant of interest by the World Health Organization (WHO), the Delta variant remains the “most concerning,” according to Sept. 7 remarks by Maria Van Kerkhove, PhD, the WHO technical lead for COVID-19.
Later today, President Joe Biden is expected to announce a multi-pronged update to the federal government's plan to address the rise in COVID-19 cases as the Delta variant surges. This includes an executive order requiring federal workers and contractors to be vaccinated against COVID-19.
Beyond the public health impetus for such moves, there is economic pressure to curb the growing rates of COVID-19 cases in many parts of the country following an August jobs report that was weaker than many economists’ expectations, which the Administration blamed on the rise in Delta variant COVID-19 cases.
These moves also come as insurers such as Humana are reporting a rise in COVID-19 hospitalizations among Medicare Advantage members, paired with an expectation that outpatient visits will decrease during the COVID-19 surge, as detailed in a recent filing with the U.S. Securities and Exchange Commission (SEC).
As David N. Gans, MSHA, FACMPE, senior fellow, industry affairs, MGMA, writes in the upcoming October issue of MGMA Connection magazine, the overall success for vaccination efforts will continue to dictate the fortunes of many specialists who are already being impacted by the Delta surge.
“An influx of COVID-19 patients has caused many health systems to cancel elective procedures, and patient volumes once again are decreasing for many specialists,” Gans writes in his Data Mine column. “Will the past be prolog to the future? If it is, we can look to the 2020 survey information for information on the strategies practice leaders should employ to optimize their organization’s performance.”
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- MGMA COVID-19 Recovery Center — Find resources and tools by subject, ranging from telehealth and safety to coding/billing and reimbursement.
- MGMA COVID-19 Federal Assistance and Advocacy Center — Stay up to date on the latest waivers, regulatory updates and relief available to medical practices throughout the pandemic.
- “MGMA Stat: Measuring the Impact of the COVID-19 Pandemic” — Find all our COVID-19 pandemic data stories in one place.
- 2021 MGMA Data Reports — Get the latest benchmarks and industry insights paired together for Provider Compensation (Provider Pay and the Pandemic), Management and Staff Compensation (Building a People-First Pandemic Recovery), Cost and Revenue (A Tale of Two Recoveries), and Practice Operations (COVID-19 Recovery and the Evolution of Medical Practice Operations).