Number of overall outpatient visits rebounds to pre-pandemic levels
However, considerable variation by patient age, geographic area, clinical specialty and insurance coverage remains.
Researchers at Harvard University, the Commonwealth Fund and Phreesia, a health care technology company, analyzed data on changes in visit volume for the more than 50,000 providers that are Phreesia clients for its report, “The Impact of the COVID-19 Pandemic on Outpatient Care.”
Related: Utilization dropping for many clinics, but telehealth use is increasing
The pandemic has dramatically altered the delivery of outpatient care in 2020: Initially, health-care practices deferred elective visits’ modified their practices to safely accommodate in-person visits; and increased their use of telemedicine. The number of visits to ambulatory care providers had declined by nearly 60% by April.
Numbers from mid-May showed a substantial rebound in-office visits that plateaued by late June. By August, outpatient visits had dropped in COVID-19 hotspots.
The latest report focuses on outpatient visits through October 10.
“As summer ended, state and local governments lifted many restrictions on travel and nonessential services,” the researchers wrote. “Like many businesses, outpatient practices and their patients have adapted to this new normal. Yet providers in some areas of the country have been facing surges of COVID-19 cases in their communities and the challenges of keeping patients and clinicians safe while also maintaining revenue.”
Other key findings include:
- While visits overall have returned to levels before the pandemic, they vary by several factors, including age group. For example, visits for younger children remain substantially below the pre-pandemic baseline.
- The rebound in outpatient visits also has varied according to what type of insurance people have. Visits by Medicare patients, for instance, now exceed the number during the week before the pandemic began.
- The extent of rebound in outpatient visits also varies according to provider organization size. For example, among adult primary-care providers, practices of one to five clinicians remain below baseline, while organizations of six or more are significantly above baseline.
- Initially, as in-person visits dropped, telemedicine visits rose rapidly. Since the peak in mid-April, however, telemedicine use has slowly but steadily declined.
- The percentage of all visits via telemedicine is slowly declining from its April peak. But it continues to be well above the pre-pandemic baseline of very few telemedicine visits.
- The most recent data show striking variation among medical specialties in the percentage of visits that are conducted via telemedicine. Telemedicine use in many surgical speclalities is low, but in other specialties, especially behavioral health, its use remains robust.
- Large provider organizations are using more telemedicine. For example, among adult primary-care providers, organizations of six or more clinicians use more telemedicine than practices of one to five.
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