Coronavirus could fundamentally change health care, insurance

The ups and downs of the novel coronavirus pandemic seen at the state, national and even global levels in the last few months aren't over, and already many are projecting big changes for the insurance and health care landscapes. Simply put, the ways in which the virus has upended the global economy and almost every industry under the sun means things may need to be reconsidered on a fundamental level to become more sustainable and effective.

One of the most immediate and potentially industry-altering changes engendered by the pandemic is that telemedicine has surged to the forefront in giving people the medical advice they need in a more convenient way, according to STAT News. This is true for both primary care physicians and some types of specialists, meaning patients may have more options to get medical advice – without making an appointment, potentially waiting weeks or more to see a doctor, and having a 10-minute appointment with a significant cost to both individuals and insurers.

Other issues of affordability
At the same time, with millions of workers nationwide losing their health insurance coverage due to unemployment, the cost of pharmaceuticals is likely to once again come into focus as well. The fact is that the vast majority of Americans are on at least one prescription medication, and many are on more than one, meaning that loss of insurance – or even a coverage gap – could be difficult; it may force a choice between getting the medicine they need and other necessities.

That reality now leads many to predict changes coming on the drug pricing front, the report said. This may be especially true with the recent revelations of costs for new drugs intended to treat COVID-19.

Telehealth may reshape the whole industry in the wake of coronavirus

Why telemedicine might be the path forward
Today, about 75 cents of every dollar spent on health care in the U.S. is for treating chronic diseases, and while medication certainly plays a role in those expenses, so too do in-person consultations and treatments, Washington, D.C.-based think tank The Brookings Institution found. With this in mind, however, it's important to note that there are still regulatory hurdles – at both state and federal levels – that need to be cleared to make telemedicine widely accessible and effective for everyone.

Interestingly, some of these issues may hinge on the fact that while the terms “telehealth” and “telemedicine” may be used interchangeably in most cases, they actually mean slightly different things, and more clarity around the issue could be needed to speed up necessary regulatory shifts. Specifically, the World Health Organization defines telemedicine as being specifically administered by doctors, and where distance is a factor in seeking treatment. Telehealth, meanwhile, applies more broadly.

AI plays a role
With more data being gathered via telehealth these days, care providers, insurers and others in the industry are better able to collect and interpret information to drive better decisions and notice trends before humans have the ability to do so, WIRED reported. Artificial intelligence is being used at a relatively nascent level in the sector, but is already proving effective in dealing with COVID-19 and other maladies.

For instance, one medical AI developer based in Toronto helped spot the earliest reports of COVID-19 in Wuhan, China, more than a week and a half before the World Health Organization put out its first statement announcing the virus had been discovered. Meanwhile, a separate AI algorithm developed in China is said to be able to diagnose potential coronavirus cases within as little as 20 seconds – and with 96% accuracy – based on nothing but a CT scan. AI may even have practical applications that simply make patients' lives easier, including details like making appointments and paying bills.

Bracing for impact
Even months after the coronavirus first hit the U.S., it remains difficult to get the full measure of the impact, especially as it relates to cost – and specifically for people who do not have insurance. It's expected that somewhere between 20% and 60% of Americans will eventually get the disease, and about 1 in 8 who do so will likely need to be hospitalized. Of that number, between 2% and 7% will potentially be uninsured, meaning as many as 2 million people nationwide who do not have health insurance will have to be hospitalized for coronavirus-related symptoms, based on estimates from the Kaiser Family Foundation.

That could lead to tens of billions of dollars in bills that might go unpaid. Even with federal relief money on the way, how those funds are actually allocated remains to be seen.

The fact is that, for the entire industry, it may take years to fully understand the full effects of the pandemic on operations and the bottom line. For that reason, it may be critical to have multiple contingencies in place so care providers, insurers and others can pivot successfully no matter what developments arise.