The Emergency Department’s “Crystal Ball” for 2020 and 2021

They say the only constant in life is change. That has never felt truer, as we are three quarters of the way through a year of unprecedented change. Many organizations are taking the time to pause, reflect, and ponder what the next 6-18 months will bring and how they will continue to evolve the dynamic landscape of healthcare.

While there’s never going to be a “crystal ball” to see into the future, there is an opportunity to craft data-driven hypotheses based on what has happened to date and how those dynamics will impact the future. Organizations around the nation are picking up these conversations as they approach a season that traditionally includes strategic planning and budgeting.

To address the illusive questions regarding the future of healthcare, there are a few themes that seem to make their way into most conversations, such as what to expect regarding visit volumes in emergency departments, how to deal with the financial impact of COVID-19, and how to best prepare for the “new normal.”

In this blog, we explore the ramifications of COVID-19, its impact on the emergency department in hospitals nationwide, and how telemedicine services can provide a solution.

What to Expect in Emergency Department Visit Volume

There was a 42% drop in emergency department (ED) visits nationwide in 2020. As many experienced, the rapid dip initially lasted for about 12 weeks and has slowly begun to recover, although some areas of healthcare are seeing that happen more rapidly than others. Pediatric volumes, for example, have been slower to recover from the initial COVID-19 dip.

Some have theorized that the influenza season could compound the “second wave” of COVID-19, heavily impacting ED visit volumes. However, other hemispheres, such as Australia and South Africa have published results that likely foreshadow what the United States. While there will certainly be hot-spots, as there have been with COVID-19, the flu season will likely be impacted by the proactive COVID-19 measures that have been implemented across seemingly every institution nationwide.

Experts in the field have posed that emergency department visit volumes have likely peaked for 2020. From a planning perspective, that means that most ED’s can expect to see their August and September volumes sustained through the fourth quarter of the year.

Dealing with the Financial Ramifications of COVID-19

The harsh reality for millions of Americans is that the COVID-19 pandemic resulted in job loss, and in turn, loss of health insurance. As such, the industry will likely see a shift in payer distribution, including an increased percentage of patients that are either Medicaid or self-pay. According to EDPMA, the average collection for self-pay is only 5%. Additionally, Medicare has announced that reimbursement will decrease 6% in 2021 and Medicaid has also started cutting reimbursement rates state by state.

The industry will undoubtedly continue to be confronted with the need to relieve financial pressure. Relative to the bigger picture, EDPMA estimates that ED providers’ costs are approximately 8% of overall healthcare costs, so even the most aggressive cost-savings measures in this area likely won’t have material impact on the overall margin. However, the issue will hopefully prompt conversations on how to evolve business models and improve hospital efficiency to accommodate both physicians and patients.

Preparing for The New Normal

Forward-thinking organizations have embraced the reality that there’s a “new normal” that differs from what the industry has known in recent history. This new normal implores executives to reframe traditional thinking. Those who react swiftly will be poised for success in the future.

Fear has been instilled across the nation, resulting in even highly acute patients, such as STEMI, stroke, diabetes, etc. patients avoiding the emergency department and facing adverse consequences as a result. EDs must partner with their marketing departments to rebuild a feeling of trust and safety in going to the ED, referencing the important work that has been done to proactively mitigate the spread of viruses like COVID-19.

Other healthcare strategic planning initiatives can also lend themselves to improved performance, such as setting up Observation Units in the ED to improve quality metrics and staffing a provider in triage to keep the waiting room moving. There are several market shifts in the area of staffing and it is a conversation that must continue to evolve to ensure the best quality outcomes for patients and optimal hospital efficiency.

Telemedicine Services

“If your group doesn’t have Telemedicine capabilities you will soon work for one that does.”  Has been shared as a sentiment as it relates to the market outlook of Telemedicine in Emergency and Hospital Medicine.

The Centers for Medicare & Medicaid Services (CMS) recently proposed several changes, including making 99281, 99282 and 99283 codes permanent and noting that 99284, 99285 and 99291 codes will coordinate with the public health emergency. There may also be new codes introduced, but that remains undetermined at this time.

It is still unclear if private payers will allow the same guidelines that CMS does with regards to telemedicine.

One of the most innovative solutions that is surfacing in the industry is the idea of bringing the emergency department to the patient’s home. Factors driving the change include the hypotheses that it may be a more cost-effective delivery mode in addition to it being more sustainable for specific subsets of pat, such as:

  • Elderly patients who get disoriented leaving home
  • Patients who experience increased pain when being moved
  • Patients with pets or dependents that can’t be left unattended

Bringing the emergency department directly to patients also decreases the chances of infection for patients.

With over 42% of Americans utilizing telemedicine during the pandemic, the data speaks for itself that telemedicine is here to stay and will “play a critical role in healthcare for the foreseeable future.” To learn more, watch the webinar, COVID-19 As a Digital Transformer: Telehealth Accelerates & There’s No Looking Back from Definitive Healthcare.

How Keystone Health Can Help You Recover from COVID-19

COVID-19 has had a profound impact on hospitals and healthcare organizations nationwide. Creating a strategic plan to deal with its financial ramifications and prepare for this new normal may seem like an intimidating task for you and your team, but it doesn’t need to be that way.

Keystone Healthcare provides a range of hospital services that make it easy to achieve better results. Whether you need help bridging gaps in medical billing services, compliance, or patient flow management, we’re ready to help you.

Just contact us today.