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Patient Experience After Modifying Visit Delivery During the COVID-19 Pandemic
The American Journal of Managed Care ; 2020.
Article in English | ProQuest Central | ID: covidwho-2290150
ABSTRACT
Prudent federal and state public health policies that include varying degrees of physical and social isolation and distancing have required rapid changes in the usual delivery of patient care.1,2 Among CDC recommendations are the rescheduling of nonurgent care and increased use of alternative approaches to in-person visits.2 The Coronavirus Aid, Relief, and Economic Security Act accelerated expansion and flexibility of telehealth activities.3 Physical and social distancing will likely continue for the foreseeable future and have a negative impact on what is typically a recession-proof health care economy.4 Available Knowledge Little is known about how the COVID-19 pandemic will ultimately affect practice and patient experience. An April 2020 report noted that 97% of physician practices experienced a direct or indirect negative financial impact, as evidenced by a 60% decrease in volume and corresponding 55% decrease in revenue.5 Others have reported a 30% to 70% reduction in independent primary care practice visit volume.6 Recently, a news report cited Department of Commerce data estimating an 18% annualized decline in health care spending based on the first 3 months of 2020.7 Negative financial impacts are likely exacerbated with the expansion of telehealth technology5,6 and purchase of personal protective equipment.5 One health system reported increasing telemedicine visits from 0 to 70,000 visits in a 1-month period, although it did not describe the delivery mode (ie, telephone or video).7 Medical specialties with a track record of delivering virtual care are not exempt from the pandemic's impact, as another recent report suggested that radiology practices will likely experience a 50% to 70% decrease in volume lasting at least 3 to 4 months.8 Rationale Managing immediate pandemic hazards while continuing to provide routine medical and preventive care that fulfills the patient care experience, population health, and per capita cost of care dimensions of the Triple Aim9,10 is challenging. Membership reflects diverse regional demographics and encompasses public (Medicaid, Medicare, Affordable Care Act health insurance exchange plans), private, individual, and charity care lines of business.12 Within KPMAS, medical care is provided by the Mid-Atlantic Permanente Medical Group (MAPMG), an integrated medical practice of more than 1700 physicians that includes more than 50 services and specialties. All face-to-face appointments, including behavioral health care visits, were given the option to convert to video visits as the goal. Because CMS waived guidelines requiring a license to practice in-state, it became possible to provide care to patients outside of DC, Maryland, and Virginia through telephone and video visits.
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Collection: Databases of international organizations Database: ProQuest Central Language: English Journal: The American Journal of Managed Care Year: 2020 Document Type: Article

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Collection: Databases of international organizations Database: ProQuest Central Language: English Journal: The American Journal of Managed Care Year: 2020 Document Type: Article