Covid 19

How hospitals are trying to get patients to return amid COVID-19

December 8, 2020 9:51 pm
  • Hospital volumes continue to lag, in part, due to patients’ COVID-19-related fears.
  • Hospitals have launched various advertising campaigns to address patient fears.
  • Other ways to address concerns include clinician outreach and allowing for remote transactions.

As COVID-19 continues to decline in much of the country, hospitals are using different approaches to lure back hesitant patients.

The challenge of recovering patient volumes as the pandemic declines from its peak in parts of the country was illustrated by a June 18 report from Moody’s Investors Service (subscription required). For-profit hospital findings for May included:

  • 20%-40% year-over-year declines in all surgeries
  • 30%-40% year-over-year declines for ambulatory surgery centers
  • 35%-50% year-over-year declines in emergency department (ED) volumes

“Weak ER volumes also suggest that many people remain apprehensive to enter a hospital, particularly for lower-acuity care,” the report states.

Hospitals ramp up advertising campaigns

Hospitals’ highest-profile efforts to recover patient volumes have been a series of public advertising campaigns, such as a television campaign launched by Yale New Haven Health System the week of June 22. The ads communicate the importance of seeking needed care and describe the safety plans the hospital has implemented.

That campaign was driven, in part, by declines in the number of patients seeking care for heart attacks (50% from mid-March) and strokes (30%), said Christopher O’Connor, executive vice president and COO of Yale New Haven.

The campaign’s goal is “to communicate to patients that it is safe to come back and that we are highly discouraging any delay in care,” O’Connor said in an interview.

Such campaigns come as many high-end businesses have changed their business models from emphasizing high-touch personalized care to offering “no-touch” transactions to address customer fears, said Mark Smith, MD, a senior adviser on provider issues for Leavitt Partners.

“For some time to come, treatment notwithstanding, hospitals and other healthcare facilities are going to be battling for the minds and allegiance of patients to try to understand: Do we want more human contact, or are we really trying to minimize unnecessary contact,” Smith said. “That’s part of the reason it will interesting to see how effective these campaigns are.”

AMCs offer lessons in recovery

Ralph Muller, a national adviser for Manatt and former CEO of the University of Pennsylvania Health System (UPHS), said that organization has recovered 90% of its pre-COVID volumes. Many academic medical centers (AMCs) around the country have had strong recoveries in their volume, which may stem from the morbidity level of their patients, Muller said in an interview.

But Muller also credited a variety of outreach efforts by UPHS, including:

  • Digital communications urging patients with serious conditions (such as cancer and heart disease) to return
  • Texting and other digital outreach explaining COVID-related safety measures
  • Providing guidance on what to expect and steps to follow when patients come to the hospital
  • Directing extra environmental staff to frequently clean public spaces
  • Cleaning exam rooms after each patient discharge
  • Performing nonemergent evaluations by phone or online before the patient comes to the ED
  • Placing calls to previously scheduled patients by surgeons, nurses and other clinicians to address fears
  • Enhancing the interactivity of the organization’s website, such as by adding chatbots
  • Offering Q&As and FAQs on the website to address concerns by patients in different disease groups

“A lot of the anxiety a patient may have had a month ago, based on all of the press coverage, was met in large part by having that personal expression from the nurse and the doctor,” Muller said.

The effort was facilitated by UPHS’s increased use in recent years of care coordination outreach, as encouraged by value-based payment models.

Common COVID-related safety steps by healthcare organizations nationally, Muller said, include taking patients’ temperatures and testing most staff and patients before procedures. Although testing all staff is not included in guidelines from the Centers for Disease Control and Prevention, Muller said some healthcare organizations are doing it to ease safety concerns of patients and staff.

UPHS also requires patients to text staff when they are arriving for scheduled care to ensure space in waiting rooms is sufficient to meet social distancing requirements.

Preregistration steps, including the collection of personal and insurance information, have been moved online for patients to perform before they go in for elective procedures. Similarly, checkout paperwork is conducted online after a patient leaves the facility.

“Almost all [AMCs] are doing these kinds of steps,” Muller said.

Some patients scheduled for elective procedures at AMCs, such as those seeking hip or knee replacements, have balked at returning due to COVID fears, Muller said. Usually, they ask to wait a few months before moving forward with the procedure.

The challenge with such patients partially is mitigated through the system’s increased use of telehealth, which at least allows for ongoing monitoring of their health.



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