Phrases like “the new normal” and “the recovery period” have become almost as common as the term coronavirus. Little did we know prior to March of 2020 that was life as we knew it as an industry was about to change. Lest you think we’re still lightyears away from a pendulum swing that will change the face of healthcare as we know it, think again. The time to act is now.

In a recent Women In Healthcare webinar hosted by Advisory Board and sponsored by HGA, Advisory Board’s Rae Woods examined the most important strategic questions facing healthcare leaders as we emerge from the acute phase of the pandemic. The top takeaways from Woods’ presentation are highlighted in this article.

Takeaway #1: We have a narrow window of opportunity to shape the future right now.

Woods said it best—this is close as we will ever get to starting the industry from scratch. For many years the healthcare industry has heard rumblings of a better way, from everything to virtual health to value-based care (VBC).   We are now living in a moment where it’s time to make these ideas a reality.

As Woods described, this period of time known as the peri-COVID-19 era, presents opportunity to be agents of change for things like telehealth, home-based care (HBC), transparency, physician partnership and health equity. Each of these entities have accelerated drastically in the wake of the pandemic, and it’s up to healthcare leaders and policy makers to work together to at least maintain if not strengthen the momentum. It’s important to understand that while some dynamics of power have shifted in the industry since March of 2020, many have not. As we look to the future, it’s up to us to take actionable steps to shape the trajectory of the structural shifts (and cracks) that make up our system.

Takeaway #2: We have to uncover the reasons behind the staffing crisis.

While there are many nuances in the way we live and work in the peri-COVID-19 era, the biggest revelation that many hospital and healthcare leaders face today relates to staffing. There is an abundance of people at all levels (re: not just frontlines). According to Becker’s Hospital Review, 24% of U.S. hospitals have reported a critical staff shortage.  Registered Nurses (RN) are leaving systems in droves to pursue other means of work, such as travel nursing, while some are leaving the industry altogether. New Jersey State Nurses Association reports a national average of 18.7% staff RN turnover in 2020, which is up from 15.9% in 2019. 

As Woods explained, it’s simply not enough to accept the numbers and continue business as usual. Rather, hospitals need to identify the root of the problem and seek to find solutions that prohibit what is being referred to as “the great resignation.”

Upon digging a little further, it can be found that burnout is a big reason for the mass exodus. Nurses aren’t the only ones suffering. Many physicians are feeling the heat. According to a Physician Retention Survey conducted by Jackson Physician Research, 27% consider leaving for a new employer, 11% consider early retirement and 8% consider leaving medicine entirely. Additionally, a record 47% of clinicians report that burnout has a severe impact on their life. Increasing pay for physicians, nurses and all of the countless other roles that are needed to keep hospital operations running is simply not enough to combat the greater issues at hand, like burnout, for example. As Woods described, it’s a temporary fix.

Takeaway #3: We Need to Remember Change is Ahead, not Behind

With the weight of so many changes still being felt from the past two years, it can become difficult to narrow down where we need to focus our efforts. Woods defined the primary areas of opportunity as:

  • VBC + Corresponding Payment Models
  • Virtual Care
  • HBC
  • Health Equity

Each of these areas has a wealth of room for growth, so here are the highlights.

  • VBC + Corresponding Payment Models: Compared to the early phases of the pandemic, providers are more willing to accept risk-based payment models, said Woods. However, many want to see more guidance from the Centers for Medicare and Medicaid Services (CMS). Woods explained that of the 54 models tested by CMMI since 2011, only five have produced meaningful savings and most have lost money. There needs to be greater emphasis from CMS on prioritizing models most likely to achieve savings or improve quality.
  • Virtual Care: Virtual care has been the area to watch for many years, but especially the last two. There has been more alignment with health plans and virtual care platforms. The question, says Woods, is where can it be deployed first? There has been greater excitement around virtual care for behavioral health as of late, compared to the pre-pandemic days where the emphasis was on urgent care. According to Woods, there isn’t much discussion on the looming question of how much telehealth we’ll see in the future. However, she did implore us to answer the more urgent question of who will be delivering virtual care in the future. That will determine how much of it we’ll see.
  • HBC: HBC has seen an explosion of sorts and appears to be full steam ahead in the wake of the pandemic. Companies like Kaiser Permanente and Mayo Clinic have invested $100M in a hospital-at-home company called Medically Home. President Biden has proposed $400B for HBC, and many in the field argue that it’s better for patients and providers when care takes place at home instead of the confines of the hospital. Woods did prompt us with some tough questions that demand answers, including: how does HBC exacerbate an already fragmented healthcare system? How does HBC strain staffing supply? And lastly, how does HBC worsen health equities? At the end of the day, it’s important to think about who benefits from these models.
  • Health Equities: Health equity is the 800-pound gorilla in the room. COVID-19 put inequities in the spotlight in a major way, and as Woods said, “for a damn good reason.” Woods encourages us to consider three pillars when it comes to health equity. The first is workforce. It’s imperative that we create a diverse workforce that reflects the demographics of the community through all levels of the organization. Next up is patient outcomes. Ensure equitable outcomes for patients by guaranteeing that all of their physical, behavioral and social needs are met and disparities are reduced at point-of-care. Finally, enhance community efforts. Address community-wide Social Determinants of Health (SDoH) by focusing on root causes. Everyone has to work together.

In Closing

Woods closed out the webinar by posing a very simple yet important question: what do we want our future to be? Furthermore, if the time to act is now, how can we better support our healthcare workers to stay committed to their profession and enhance change across the areas mentioned above?

Education is a great way to start. Webinars like this one open a dialogue and encourage collaboration across the industry that is greatly needed. By learning more about the issues at hand, we will be better equipped to step up to the plate and take the next right step. Onward and upward!

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