Pandemic, disparities, trust erosion challenge health care

Improving the health care system while negotiating the pandemic created significant challenges for the health care industry, according to Manatt Health, which updated its 2021 list of 10 health care imperatives for the 2020s “Navigating Through The Surges.”

Two years into a new decade and two years into a pandemic, one health care executive described the current health environment as “living our life in surges.”  Manatt’s experts gave an update on these health care imperatives during a webinar on Tuesday.

As COVID-19 took hold, said Darrell Kirch, Manatt national advisor, there were several challenges that made the situation even more dire. Those challenges included:

• Erosion of trust. The present time when even well-proven science is mistrusted is unprecedented, he said. “We are living in a time when our emotions make more sense than facts.”
• Epidemic of behavioral health disorders. This was not caused by the pandemic, Kirch said, but was deepened by it, especially in the wave of behavioral health disorders among children and adolescents.
• Persistent and widening disparities. This was proven by the large numbers of minorities who became sick, hospitalized and died during the pandemic.
• Chronic health care workforce shortages and distresses. These also existed prior to the pandemic, Kirch said, but more clinicians say they are suffering from burnout.

Manatt Health analysts broke down the 10 imperatives.

1. Ensuring access. More people in the U.S. have comprehensive health coverage today than at any time in history, said Julian Polaris, Manatt Health associate. The pandemic has led to “robust increases” in the number of people with coverage, but many of those coverages will expire in the near future, he cautioned. Polaris said we can expect to see a significant number of people lose their coverage when the public health emergency ends in July.
2. Achieving health equity. Health equity “means everyone has the opportunity to achieve their healthiest life,” said Linda Elam, Manatt Health managing director. “We made a lot of progress toward advancing and achieving health equity. But we have much more work to do.”
3. Stabilizing the safety net and rebuilding public health. “Safety net hospitals” that serve individuals in low-income communities “need a bit more love, a bit more attention and a significant amount of investment,” said Ebone Carrington, Manatt Health managing director. She added that many safety net hospitals were on the brink of insolvency prior to the pandemic, but the pandemic exposed their fragile financial situation. Among the challenges faced by these hospitals, she said, are difficulties in recruiting staff and lack of access to funding that would enable them to transition to offering telehealth.
4. Addressing social drivers of health. The health care system can’t attain its goals without addressing the social drivers of health – including issues such as housing and food insecurity – said Elizabeth Osium, Manatt Health director. The two key components to be successful in this area, she said, are new infrastructure and community investment.
5. Helping children achieve their potential. COVID-19 imposed many disruptions on children and teens, which were “truly devastating for their health and development,” said Jocelyn Guyer, Manatt Health managing director. Compounding that, she said, is “an unprecedented mental health crisis among children and youth.” The incidence of drug overdoses is also ravaging young people, she said – not because kids are necessarily using drugs more “but they are dying more because of them.” In addition, Native American, Black and Hispanic children were more likely than white children to lose a parent to COVID-19.
6. Innovating long-term care. “We can and must do better for the millions of older Americans and people with chronic conditions who want to receive care at home,” said Stephanie Anthony, Manatt Health senior advisor. She also pointed out that nearly one-quarter of the COVID-19 deaths in the U.S. occurred among nursing facility residents and staff. Anthony said she believes people can receive appropriate care in their homes, if they choose, as long as they have access to appropriate supports.
7. Accelerating digital health care. Almost everyone has tried telehealth at this point, but how does the health care system sustain the program in telehealth made over the past years? The key, said Manatt Health director Jared Augenstein, is reimagining clinical care models and how they can be redesigned. In order for that to happen, he said, we need “to expand base on digital health care.”
8. Advancing academic medicine. The shortages and stresses of the clinical workforce brought home the urgency of preparing the workforce needed to meet health care’s needs, Kirch said.
9. Delivering breakthrough treatments. The past two years saw “remarkable developments in vaccines and MRNA technology developed and brought to market in a quick time frame,” said Michael Kolber, Manatt Health partner. The research and development pipeline that brings a drug to market is becoming more costly, he added. Regulation on prescription drug pricing is putting pressure on manufacturers.
10. Securing health data. Alex Dworkowitz, Manatt Health partner, said the increasing amount of data on patients has raised two challenges: securing data against hackers and the questions of privacy. The top priority in data security, he said, is ensuring that those who are entrusted with that data have the capacity to protect it.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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