Missed Care Opportunities During the Pandemic

Over the past year, our nation has focused on the direct effects of the pandemic such as death tolls, hospitalizations and probable and confirmed cases of COVID-19. However, as vaccine distribution begins to ramp up, we have a new health concern – the indirect effects of the pandemic. Most notably, the decrease in non-COVID related medical care during the pandemic. Missed care could lead to detrimental health effects caused by undiagnosed illness and disease.

A study published in The Journal of the American Medical Association (JAMA), that included 6.8 million individuals on employer health plans found a significant drop in screenings during the first two months of the pandemic. In March and April of 2020, colonoscopy procedures dropped by 69.6% and the number of mammograms dropped 67% from the year prior. Even child immunizations for those under the age of two were down 22.3%. In general, decreases of 47.4% were observed for musculoskeletal surgery, 59.8% for cataract surgery, and 45.0% for MRIs.

In contrast, in these first pandemic months telemedicine visits increased 4,000%. However, most of the screenings listed above cannot be performed via a telemedicine visit. Ultimately, researchers concluded that the increase in telemedicine only made up for about 40% of the overall decline in office visits.

Following the initial care utilization decrease in the first months of the pandemic, screening rates seem to have mostly rebounded. Between June and September of 2020, Massachusetts General reported that screening rates were back up to about 85% of normal rates.

While this rebound to relatively normal screening rates is a good sign, current rates do not show that those skipping screenings at the onset of the pandemic are racing back to their physicians for care. Avoidance of medical care could lead to missed opportunities to manage chronic conditions, missed detection of new conditions and an increase in morbidity and mortality associated with treatable and preventable health conditions.

As an employer, you have a direct interest in the health of your employees. While a decrease in claims may have provided much needed temporary financial relief at the beginning of the pandemic, you do not want those lost opportunities for care to lead to larger and more costly health events in the future. Focus on recommunicating your medical benefits to employees. Focus on free preventive care. Remind employees of age and gender specific screenings. And, if you are able, offer an incentive to help motivate employees to see their physician.

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