Health care after the pandemic: Emerging issues for 2021
A new report from PwC tackles everything from the explosion of virtual care, to the latest changes in clinical trials and supply chains.
A new report by the PWC Health Research Institute outlines the top health care industry issues of 2021, describing a system struggling to respond to an ongoing pandemic while planning for an uncertain future.
The wide-ranging report tackles subject such as the explosion of virtual care, how digital relationships are changing for providers, the latest changes in clinical trials and supply chains, and industry forecasting and investment challenges. In gathering data for the report, PWC surveyed more than 2,500 consumers and interviewed executives from health systems; insurance carriers; pharmaceutical and life sciences companies; academics; policy experts; and representatives of industry trade associations.
Related: Temporary savings: Pandemic lowers health care spending trends in 2020
This two-part series will first look at changes for providers and consumers, especially in the area of virtual care.
Virtual care—a new approach still in transition
The report starts out by acknowledging the obvious; the COVID-19 pandemic has had a big impact on health care, and Americans may see far-reaching changes to how the industry delivers care to patients in the future.
One of the biggest impacts is the explosion of virtual care—the pandemic forced many health systems to turn to online visits, especially in the early months of the crisis. The study noted that providers often struggled with this new approach.
“The pandemic generated uneven experiences for millions of Americans as physicians, therapists, nurse practitioners, hospitals and other caregivers—all coming to telehealth with varying levels of experience themselves—tried suddenly to meet patients where they were. Some virtual visits happened on nontraditional mobile platforms, on personal phones, through texts and through messaging platforms more often used for sharing family photos or internet memes with friends,” the study said.
Providers and health systems are still figuring out how to best deliver care through these new platforms, the report said, and payers are also working out how pay for care as consumers continue to use virtual visits.
Unequal telehealth results, depending on the type of care
A consensus has emerged that mental health services are particularly well-suited for online visits. The PWC report found that 58% of health system executives said they would continue to offer virtual mental health visits in 2021. This was followed by family medicine (56%); obstetrics and gynecology (46%); and pediatrics (44%). However, they also noted that obstacles to telehealth adoption remain: 52% of health system executives said reimbursement challenges were “very significant” with telehealth programs.
For mental health, growth is expected in the virtual care arena. PWC found that 43% of health care executives said their system offered telehealth for mental health services in 2020. But for 2021, 58% said they plan to offer telehealth options for psychiatry and other mental health services.
Primary care services delivered via telehealth garnered mixed reviews. The PWC report said that although 92% of health systems have used telehealth for primary care delivery, only 17% found it useful for ongoing care management. A higher number of respondents, 68%, said it was useful for follow-up appointments with patients.
Consumers reported a mixed experience with telehealth overall, and racial disparities emerged as an issue with the PWC research. Although half of White patients (51%) said they did not encounter any issues with telehealth visits, that number dropped to 34% for Black respondents, and 35% for Latinx respondents. Reports of technical issues with the visits were in roughly the same range: 27% of White patients, 28% of Black patients, and 24% of Latinx patients said they had technical issues with their virtual visits.
Other issues encountered by consumers included uncertainty about follow-up care, health problems that could not be addressed by a virtual visit, and discomfort with being on video for health care visits. Again, some racial disparities were seen: for example, uncertainty about follow-up care was reported by only 7% of Whites, but 20% of Blacks and 21% of LatinX respondents said they were not clear on follow-up care instructions.
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