Jump to content

Coronavirus and Healthcare: How a Pandemic is Improving Our Healthcare System

Disasters Article Video   (936 Views | 3 Replies | 793 Words)
by ValinMNG ValinMNG (New) New Nurse

ValinMNG has 5 years experience .

2 Articles; 1,324 Profile Views; 8 Posts

Covid-19: What's worked?

The fissures in our healthcare system have been highlighted extensively over the last two months--let's look at what's worked.

Coronavirus and Healthcare: How a Pandemic is Improving Our Healthcare System
Share Article

In the wake of a dramatic surge of COVID-19 cases in many cities across the country, our healthcare system is forced to favor efficiency over profit. Several barriers have been removed for providers that allow for improved patient care like the elimination of prohibitive licensing requirements and equitable reimbursement for telemedicine. Though these measures are highly advantageous in a world without COVID-19, our profit-driven healthcare system never facilitated their growth. This pandemic underscores the dire need for healthcare reform—and, just maybe, this pandemic will be the catalyst for long-term changes.

On the removal of restrictive healthcare licensure requirements:

I am a registered nurse with an active nursing license in Washington State but the law does not allow me to work as an RN in Missouri (where I live and go to school) until I submit an application and receive approval after a lengthy review process with the Missouri Licensing Board. I could be helping right now. I want to be helping right now.

State healthcare licensure is convoluted for the majority of healthcare professions. Individual state licensure requirements were initially enacted to protect the public from medical incompetence in the late 19th century. However, because healthcare programs are accredited by national bodies and, well, because healthcare education is evidence-based there is no obvious need to continue this way.

These unreasonable requirements often deter providers from obtaining licenses in multiple states and result in lost opportunities for providing healthcare. When we consider providers living along state lines (like in St. Louis, MO) or the relevance of telemedicine (which brings healthcare to those who cannot physically access it)—we realize the importance of removing licensing barriers.

The good news is, several states have temporarily loosened their licensing requirements to allow for healthcare providers to work across states. The most notable example of this is New York issuing an executive action to allow physicians, nurse practitioners, nurses, and physician assistants to practice in NY as long as they are in good standing in their respective states. The bad news is, several states (like Missouri) do not have any legislation allowing for outside providers to practice during the pandemic. If healthcare personnel in Missouri are no longer able to provide adequate care because they are overwhelmed with the volume of patients, people will perish at the behest of outdated legislation.

On the increased use of telemedicine:

COVID-19 has spurred a dramatic growth in telemedicine use for two reasons 1) doctors still provide care to patients for chronic diseases, pregnancy, and mental health—but requiring office visits put patients at additional risks and 2) to keep coronavirus patients who do not need hospital care at home to prevent the spread of the disease.

The benefits of telemedicine have long been understood: it is cost-efficient, easier to access than an in-person visit for patients, and frees up valuable appointment time for more complex issues that require an in-person visit.

So, why did only 22% of providers report using telehealth in 2018 though a majority believe it is beneficial for patients? Among the top reasons are low reimbursement and aforementioned interstate licensing constraints. Out of necessity, insurance providers, including Medicare, have begun to reimburse doctors for telehealth at similar rates to in-patient visits. Effective for services beginning March 6th and “lasting for the duration of the COVID-19 public health emergency,” the Coronavirus Preparedness and Response Supplemental Appropriations Act requires that Medicare reimburse providers (doctors, nurses, nurse practitioners, and physician assistants) at the same rate as they would in-person visits and covers most conditions. Other influential insurance companies, like Aetna, have adopted similar reimbursement practices.

Improvements are important, but at what cost?

It would be remiss to not acknowledge the uncertainties of the cost of such large changes. In allowing for out-of-state providers to practice, states lose a revenue source—but, during non-pandemic times, this could be recouped if the government creates a federal licensing board and distributes fees equitably to states based on amount of providers. For telehealth, Medicare long-resisted telehealth for fear of increasing patient visits and thus, swelling costs. However, the Veterans Health Administration has been able to reduce hospitalizations by 19% and costs per patient by $6500 by enrolling patients in telehealth.

These changes will work. These changes will save lives.

Coronavirus has enhanced healthcare in two major ways and we are at risk of losing these gains if there are not adequate policies put in place to protect them. It is time to leverage the improvements being made right now for the sake of our future health.

 

2 Articles; 1,324 Profile Views; 8 Posts

Share this post


Link to post
Share on other sites

OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

881 Posts; 9,958 Profile Views

I will say it is amazing that during this time my hospital has spent money to turn all our rooms into negative pressure rooms, switched out monitors, put glass in the doors so we can look into the rooms, installed monitors outside the room so we can watch the patient's without going in. For all of this I am grateful as other hospitals across the country are not taking the same steps or making the same investments. However, once this thing is over I know it will be business as usual.

In regards to the licensure I know some states have reciprocity agreements and it isn't very hard to obtain a license in another state (as long as they have reciprocity agreement). But I do agree, to get a license in another state that doesn't have reciprocity with your home state can be a pain. That is one of the benefits of working that VA.....if you have license in one state and what to work in another it transfers over. I dont see why we can't have something like that in the future for all RN's.

Share this post


Link to post
Share on other sites

RN-to- BSN has 6 years experience as a ADN, RN and specializes in SCRN.

245 Posts; 4,928 Profile Views

I do not think the healthcare is improving, virus or not.

Share this post


Link to post
Share on other sites
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.