Not even doctors and nurses well versed in public health emergencies could have imagined when they first heard reports of a mystery respiratory illness in late 2019 that the health care system would still be reeling from it at the beginning of 2021.
However, throughout the battle against Covid-19, there's been a glimmer of hope. This year vaccines from Pfizer, Moderna and other drugmakers are slated to help hospitals and other health care providers protect their workers and the communities they serve. For the industry, inoculations are expected to bolster efforts to bring more regular and preventive services—critical to patient health and facilities' financial stability—back online.
Despite receiving billions of dollars in federal relief, health systems have continued to hemorrhage hundreds of millions of dollars in revenue with each passing month, thanks to patient reluctance to schedule visits and delayed procedures.
Though hospitals have been preparing for distribution for months, once the Food and Drug Administration granted emergency-use authorization to the first vaccine in the U.S., from Pfizer, in early December, a new urgency and outlook emerged. The first doses were earmarked for frontline and hospital workers.
"Those were probably the longest two weeks of my life, waiting for the vaccine to come," said Dr. Donald Morrish, chief medical officer at St. John's Episcopal Hospital in Far Rockaway.
With the help of the vaccine, Morrish expects, St. John's will be able to put more resources behind growing its primary and specialty care footprint on the peninsula later this year rather than beating back a pandemic. That's especially important for the population that St. John's serves, which—like many communities in the outer boroughs—has been disproportionately affected by the crisis. Rebuilding access to services will be critical to chipping away at longstanding health disparities brought to even greater light during the Covid era.
It's not just doctors and hospitals that are anxiously awaiting a turnaround.
"Covid is going to continue to be a major challenge for everybody in the delivery system and health plans," said Eric Linzer, president and CEO of the New York Health Plan Association, which represents 28 managed-care health insurers that provide services to more than 8 million New Yorkers.
The state had convened a team tasked with achieving billions of dollars in Medicaid savings to help address a deficit even before the pandemic. Insurance plans across the state will be keeping an eye on state budget cuts and what they mean for some of the most vulnerable New Yorkers, who rely on Medicaid for health coverage, Linzer said. "Continued cuts to health plan rates are not going to be sustainable," he added.
In a rare move, hospitals, health centers, patient advocacy groups and insurance plans have all convened in opposition to the state's proposed changes to the Medicaid pharmacy benefit, Linzer noted. The proposal would affect a drug discount program that allows safety-net providers, including community health centers and hospitals, to purchase deeply discounted drugs and use the savings to provide essential services for low-income New Yorkers.
Although the state holds that its proposal will save taxpayers millions of dollars by ensuring that Medicaid pays the best price for medications, many say it will end up costing the state in the long run. Patients will end up sicker because they haven't received needed care and services supported through the program, they argue.
Insurance plans also are keenly aware of the possibility of sicker patients requiring more costly care this year as their ailments worsen due to treatment that was delayed during the height of the pandemic. It's a concern for physicians as well.
"We firmly believe that routine and preventive care is an absolute requirement for reducing the overall cost of health care," said Dr. Ian Leber, chief medical officer of sprawling physician group ProHealth. "Unfortunately, these types of visits are the ones patients are most willing to forgo during this pandemic."
Adapting to virtual services has helped; telemedicine will continue to be an area of focus this year industrywide.
"Through the use of patient-friendly technologies, we have seen an astounding rate of acceptance by even the least tech-savvy of our patients and have performed up to 15,000 virtual visits per week," Leber said.
All in all, the vaccine is essential to the overall economic recovery. Dr. Teddy Lee, chairman of emergency medicine at St. John's, adds that the public at large must be willing to take it.
"People need to believe the science," Lee said.
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January 14, 2021 at 08:00PM
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Vaccine gives hope to health care industry, but challenges from Covid persist - Crain's New York Business
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