What COVID Taught Us About Reducing Hospitalizations, and Two Goals Moving Forward

Dec 29, 2022 10:00:00 AM

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As we look back at the worst days of the COVID pandemic, and assess our “new normal” of variants and outbreaks, healthcare professionals are assessing what we can do going forward to prevent the worst outcomes from continuing to occur. We know for certain that people with chronic diseases such as heart disease, diabetes, chronic obstructive pulmonary disease, chronic kidney disease and obesity increase the risk of severe illness from COVID. Diabetes, in particular, is listed among the top-five “contributing conditions” to COVID-related deaths.

What can healthcare providers do to lower hospitalization rates going forward? We can relentlessly pursue two goals to ensure better outcomes for our patients and members:

Goal #1: Get serious about preventing and managing chronic diseases.

We can and must provide better tools and support to prevent chronic diseases. That doesn’t just apply to COVID-19. Even common viruses like influenza impact those with chronic diseases more seriously.

Prevention can and should take many forms, including risk assessments, screenings, vaccinations, annual wellness visits and member education. Insurers, in particular, can influence utilization of these services by working with members and physician groups to better facilitate and coordinate care. For instance, during the pandemic, many insurance providers removed cost sharing and prior authorization requirements related to telehealth services for primary care, urgent care and behavioral healthcare and extended coverage to non-physician healthcare practitioners. They also expanded web resources to help members locate virtual providers, make appointments and log on successfully. These types of efforts encouraged members to pursue care before health challenges became critical and lead to hospitalization. They should be continued indefinitely.

A growing number of health plans also expanded adoption of wellness programs and platforms – especially mobile options – that focus on the fundamentals of nutrition, fitness and well-being, keeping the body as strong and healthy as possible. These programs can also complement disease management for the 6 in 10 Americans and 4 in 10 Canadians who already have a chronic disease. It’s well documented that small but consistent adjustments to nutrition, activity and wellness practices can reduce health risks such as blood sugar fluctuations, high cholesterol and high blood pressure that cause chronic disease to progress.

Though disease prevention measures cost money, they are incredibly cost-effective compared to hospitalization costs. Just one example: the average cost of two days of inpatient care is more than $5,200, compared to about $60 for a cholesterol test or $60-90 for an hour of nutrition counseling. Similarly, putting money into preventing chronic diseases such as diabetes, obesity and heart disease will result in savings as members require fewer hospitalizations, pharmaceuticals and other interventions throughout their lifetime.

Here’s how you can calculate potential medical cost savings by offering a digital chronic disease prevention program as an added benefit to members.

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Goal 2: Get creative to improve access and utilization.

We’ve seen with COVID how delays in prevention and early-detection practices led to more advanced disease later. During the throws of the pandemic, people delayed preventive services for different reasons: for a time, because doctors’ offices were closed and non-emergency appointments put on hold; then, when offices reopened, out of fear of contracting COVID, or because they had lost their jobs and health benefits, or they simply lacked the motivation and know-how to restart healthy habits.

The lesson for healthcare-related professionals is that we must be more creative in the ways we offer preventive services. Use of telehealth, which grew more than 8,000% during COVID, is a perfect example, because it reaches patients where and when they need it, and often at a much lower cost than in-person visits. Mobile health clinics also reach populations that might otherwise have access obstacles. For instance, some health systems utilized a mobile mammography bus or set up vaccination clinics in churches, community centers or at local fairs and festivals. When you bring preventive care to the public, rather than waiting for them to initiate, rates of utilization increase exponentially.

Another important option for chronic disease prevention services is digital health platforms. For instance, Yes Health partners with insurers and employers to offer three programs on its all-mobile health coaching platform: Diabetes Prevention, Healthy Weight and Concierge Health. Members can interact with both human and virtual coaches right from their mobile devices, when and where it’s convenient and effective for them. Because of this, engagement and retention remained high during the pandemic, especially in terms of wellness logs and interactions with our coaches. People were seeking guidance on how to cope with the worry and stress, and how to build new healthy habits in the void of normal routines. These types of wellness-focused technologies should continue to play a part in prevention services well into the future.

Next steps

The pandemic exposed weaknesses in the U.S. and Canadian health systems, but it also revealed emerging strengths and many opportunities. Among those, the growing willingness of various sectors of health services to develop partnerships and more seamlessly coordinate care. 

Preventing chronic disease is central to this effort, and for good reason: it reduces disease severity, hospitalization, treatment costs and, most importantly, suffering. At Yes Health, we’re committed to being part of that movement, helping members adopt healthier lifestyles for a longer, fuller life free of chronic disease – today and long after the pandemic.

To learn more about Yes Health’s powerful 3-in-1 platform, read our Yes Health for Insurers guide. You can also see it in action by scheduling a demo.