The most prominent topic in healthcare today is COVID-19. All healthcare areas felt the pandemic’s effects, and no practice was immune to the financial challenges resulting from the virus.

Mary Tucker, CEO of UPIC Health, brought together a panel of healthcare experts to discuss these challenges and get some insights on how practices can manage to continue providing essential community services while battling the virus. Dr. Jamal Mahdavian, Solo Practitioner in General Surgeon, Health Alliance of the Hudson Valley in Kingston, NY, Dr. Gary Smalto, Vice President at Optum Advisory Services and Practice Partner Health System Performance Improvement, and Kevin Sexton, Managing Director of the Berkeley Research Group and retired CEO of Holy Cross Health, joined Tucker to talk about healthcare’s current state.

Sexton viewed the COVID-19 experience as a stress-test for the entire healthcare system.

“I would say there are three or four things we need to take a look at seriously going forward,” Sexton said.

He noted that, when the pandemic halted elective procedures during the spring, that placed a huge financial burden on the system and showed the healthcare industry’s fragility. The pandemic also uncovered the disparity in care for certain underserved groups in the United States.

“The net result was the system got in trouble, and we didn’t do a great job of delivering care and at least getting equal results for people in need,” he said.

Dr. Mahdavian pointed out that the United States’ employer-based insurance system also became an issue during the pandemic.

“As soon as you lost your job, you lost your insurance, at least within a certain amount of time. Most blue-collar jobs can’t be done from home,” Mahdavian said. “Even in the medical profession, itself, there is no ‘at home surgery.’”

“We’ve used our medical system as a way to treat case-by-case,” Dr. Smalto said. “And we really haven’t thought about covering populations. And what we’ve learned with COVID is that organizations, particularly healthcare systems that had risk contracts and populations under risk already, did better than organizations that primarily had fee for service. What that shows you is that fee for service is a risk model, and we didn’t know it.”

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