COVID-19 Meets Flu Season: Guidance for Medical Practices

COVID-19, meet flu season.

Medical practices have overcome more obstacles than ever while handling the public health emergency. Balancing patient needs, personal safety concerns for providers and staff, and bottom-line business needs has been daunting for most.

Now, the situation is poised to become even trickier.

Coming into the fall, medical groups anticipate a resurgence of COVID-19-symptomatic patients. At the same time, they are continuing to accommodate the backlog of pent-up demand from the first shutdown this spring. Providers are motivated to stay open and ensure their patients have access to appropriate and necessary care. And underlying all of this, they have a financial imperative that would hamper a second shutdown.

Medical practices need to take the lessons learned from the first surge and create a plan to coexist with COVID-19 and flu season.

Systems must be prepared with an operational and financial plan to adapt on a moment’s notice to maintain high quality and safe patient care, and communicate their plans to employees, patients and the public. This will ensure confidence and provide a smooth transition to whatever the operational changes entail.

Below are the four key areas of focus with critical action items to incorporate into your fall and winter operational planning.

Patient Communication and Activation. Patients will want to know about changes to clinic hours, telehealth options, screening protocols during in-person appointments, visitor and waiting room restrictions, new pick-up or drop-off routes, and other adjustments they’ll be expected to make during a visit. From the provider perspective, it will also be nice to inform them of all of the strategies the practice is undertaking to ensure patient safety, from increased cleaning of patient spaces to socially distanced waiting rooms and the requirement of masks.

Patients will often check social media pages and your website for the latest information, and call in if they have questions or concerns. Practices that update their scripts, messaging and external communications channels (and make it clear with a timestamp or date as to when the latest updates were published) can assuage patient concerns before they arise.

• Update and publish scheduling changes to your health system’s website, practice-specific webpage and via social media pages.
• Commit to and publish screening protocols so that both patients and staff know ahead of time what to expect.
• Ensure all automated phone scripts are updated, and that live and call center staff are trained with updated Q&As and proper protocols so they can respond to inquiries about screening protocols, visitor restrictions and more.
• Utilize your patient portal to remind patients of important appointments, such as their annual check-ups, and provide information around alternative site locations or telehealth options.
• Reach out to local news media to stay ahead of community-based communications regarding your future plans so the public knows you have a well-thought-out and detailed plan to ensure their safety.

Clinic Operations. A surge in COVID-19 cases will likely relegate practices to providing more virtual care, as many did this spring. Practices should use the next few weeks to map out their telehealth strategies as well as their staffing plans, including back-up clinicians who can sub in if practitioners are sick. They should also work with their materials resource management teams to discuss supply availability for ambulatory providers.

• Seek feedback from your physicians and clinicians around their telehealth experience and implement any changes they suggest. This time around, practice leaders have time to proactively optimize the provider’s virtual experience, meaning they can drive higher utilization during times of limited or closed in-person locations.
• Prepare staff for a return to virtual work, including telehealth protocols, and provide necessary home office supplies.
• Work within the system to try and establish a float or call pool so that medical practices have clinicians who can step in if staff calls out.
• Create a constant communication channel with system purchasing to ensure there is a ready and steady supply of personal protective equipment specifically for the clinics. Consider whether you need to supplement traditional purchasing by using a trusted e-Commerce marketplace, and continue to practice vigilance to prevent e-Commerce fraud in your supply chain during COVID-19.

Scaling by Specialty and Associated Effects on Capacity. Most healthcare providers scaled back non-emergent or elective procedures this spring to accommodate COVID-19 planning and capacity. Now, to adapt to the anticipated increase in visits between cold and flu season as well as COVID-19, providers’ capacity planning will be critical.

• Create and communicate a clear plan for scaling services based upon defined data points such as patient acuity, number of available ORs and number of available beds. This allows providers and staff to anticipate the potential impact to their practice and enables them to prioritize the demands and needs of their patients.
• Challenge service line leaders to rethink the types and care locations of their procedures in case the need arises to shift to more to outpatient surgeries, office-based procedures or an ambulatory surgery center (where applicable) in order to conserve inpatient beds.

Financial Recovery. In our recent analysis of how COVID-19 is reshaping ambulatory revenue, volumes and operations, our projections showed that some practices were on track to return to their pre-pandemic baseline volumes by the end of the summer, while other groups may see volumes fully return toward to the end of the calendar year. Providers’ financial recoveries are closely tied to how they have been able to scale visits, both in person and virtual.

Virtual visits hit record usage during the first COVID-19 wave, increasing 149X in aggregate between March and May, according to our healthcare database. Premier has successfully advocated for an expansion of telehealth during the pandemic and is now supporting permanent policy changes to modernize the Medicare telehealth benefit, ensuring more patients have access to these services and that providers are adequately reimbursed for them.

• Stay informed around the fluctuations in state and national payer regulations, and prepare to bake shifting patient behaviors into the budgeting process. Premier keeps the industry up to date on the latest healthcare policy throughout the week so providers can plan accordingly.
• Work with the revenue cycle team to create a process for collecting copays, even for virtual visits.
• Support your patients’ with financial counseling so they can sign up for coverage or work on a payment plan that fits within their means.

Medical group leaders will need to remain vigilant and be nimble this fall and winter.

They will simultaneously be planning to coexist with a potential second wave of COVID-19; manage through the seasonal viruses whose symptoms could be confused with COVID-19; and remain financially viable.

Staying ahead of the curve and creating a plan for a potential resurgence will help medical group leaders minimize disruption to clinic operations.

Our advice: Utilize the first wave successes and failures to inform future decision making. And, seek out opportunities to hear from other health system leaders throughout the country around their experiences and responses to inform your efficacious preparation.

We’re bringing together a panel of medical group leaders Friday, Sept. 25, at 1 p.m. ET to discuss best practice strategies for dealing with a resurgence and managing through daily operations. Join us.

Further reading:

• A Medical Group Leader’s Guide to Navigating Post COVID-19
• How COVID-19 is Reshaping Ambulatory Revenue, Volumes and Operations
• Four Post-Pandemic Realities Facing Medical Groups