Access to Care, Health Equity Lagging in the US; Is Telehealth Safer Than In-Person Care?

Jacqueline LaPointe

August 2021

The US ranked last when it came to access to care, health equity, and other measurements of healthcare, while telehealth may prove to be a safer option for patients.

Right now, the US may boast the most medals from the Olympic Games Tokyo 2020. However, new research shows that the country is lagging in most healthcare metrics, including access to care and health equity. In other news, data suggests that telehealth could be a safer option for patients and small businesses look to self-funding options.

US SPENDS THE MOST, BUT COMES OUT LAST

The United States ranked last on measurements of health equity, access to care, administrative efficiency, and healthcare outcomes compared to ten other wealthy nations, the Commonwealth Fund recently reported. Yet, the US still spent the most of its gross domestic products on healthcare.

Additionally, the US lagged behind comparable countries in terms of healthcare affordability.

“U.S. disparities are especially large when looking at financial barriers to accessing medical and dental care, medical bill burdens, difficulty obtaining after-hours care, and use of web portals to facilitate patient engagement,” the report stated.

The only measure the US performed favorably on was in the care process domain, which researchers attributed to the success of preventive care and patient engagement.

IS TELEHEALTH SAFER THAN THE DOCTOR’S OFFICE?

According to a new study, the answer is yes, at least when it comes to flu season.

Researchers from the University of Minnesota, Harvard, and athenahealth found that people who went to the doctor’s office after someone infected with the flu had visited were much more likely to get the virus themselves. However, that increase was not seen in people seeking treatment for medical issues like UTIs.

The data indicates that telehealth and other means of virtual care can reduce the chance of infection among patients.

“Our findings highlight the importance of infection control practices and continued access to telemedicine services, as health care begins to return to pre-pandemic patterns,” Hannah Neprash, an assistant professor at UM’s School of Public Health and one of the study’s authors, said in a news release issued by the university. "In-person outpatient care for influenza may promote nontrivial transmission of these viruses. This may be true for other endemic respiratory illnesses too, including COVID-19, but more research is needed."

SMALL BUSINESSES EYE LEVEL, SELF-FUNDING FOR EMPLOYEE COVERAGE

A new trend is emerging among small businesses. A recent study from the Robert Wood Johnson Foundation shows that small businesses are shifting toward level- and self-funding for healthcare insurance coverage over the individual health insurance marketplace.

This shift occurred during the COVID-19 pandemic, possibly because employers were less inclined to deny needed coverage to workers. Additionally, health benefits are one of the few ways small businesses can compete with their larger peers in this worker-driven environment.

But the trend could change with implementation of the American Rescue Plan’s new individual health insurance marketplace subsidies.

CHILDREN’S HOSPITAL USES DATA ANALYTICS TO IDENTIFY CARE GAPS

Ann & Robert Lurie Children’s Hospital in Chicago leveraged data analytics capabilities to flag pediatric care gaps and do something about them during the COVID-19 pandemic.

“If you don't have the analytics to show where you're at, you may not understand what's happening out there in the market. We were able to use the analytics to show there's been a big decrease, and then we quickly put together a response plan, including communication, radio ads, other types of communication channels, to respond to that,” Scott Wilkerson, chief integration and business development officer at the children’s hospital, told HealthITAnalytics during an interview.

The insights gleaned from the data were key to maintaining appropriate access to care during the pandemic and could be a strategy for balancing in-person and virtual care as communities decide how to stay open and protect residents from rising COVID-19 numbers.

FDA EXPANDS EUA FOR INVESTIGATIONAL COVID-19 ANTIBODY COCKTAIL

The FDA recently updated the emergency use authorization for Regeneron’s investigational COVID-19 antibody cocktail, REGEN-COV, to include its use in individuals with post-exposure prophylaxis. Providers can now administer the drug monthly to qualifying patients if they are at high risk of severe disease and have not been fully vaccinated or who may not mount an adequate response to vaccination.

Now, the drug is the only COVID-19 antibody therapy currently available across the US for both treatment and post-exposure prophylaxis.

The expansion of the emergency use authorization was based on results from a Phase 3 clinical trial, which showed that REGEN-COV reduced the risk of symptomatic infection by 81 percent in individuals who were not infected with COVID-19 when they entered the trial.

Previous clinical trial data also found that the drug reduced risk of death by 20 percent in patients hospitalized with COVID-19 who had not mounted their own immune response.

ANTITRUST AGENCIES MAY TARGET VERTICAL INTEGRATION DEALS

The Biden-Harris administration has made consolidation in healthcare a top priority for antitrust agencies and HHS, per a recent executive order. But this doesn’t just mean the colossal deals making headlines (e.g., the recent Beaumont-Spectrum Health merger).

Industry experts believe the executive order could mean greater focus on vertical integration deals, such as those between hospitals and physician practices and those between payers and physician groups.

“We’re going to see more scrutiny in these areas, particularly with the new vertical merger guidelines the FTC and DOJ issued in 2020. That is certainly top of mind to the FTC and the FTC has substantial experience with hospital-physician consolidation and continues to actively study its effects on competition and quality,” Ken Vorrasi, antitrust litigation partner at Faegre Drinker, told RevCycleIntelligence.

Source: https://healthcareexecintelligence.healthitanalytics.com/news/access-to-care-health-equity-lagging-in-the-us-is-telehealth-safer-than-in-person-care