The Newest Trend in Healthcare Utilization

In the United States, a large portion of healthcare spending is incurred by a small percentage of the population. That’s nothing new. Neither is the fact that the U.S. spends more money on healthcare - approximately $3.6 trillion and 18 percent of the gross domestic product (GDP) – than any other developed nation. 

One thing that has changed, especially in recent months, is the utilization of healthcare. Healthcare utilization is defined as the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well-being or obtaining information about one’s health status and prognosis. It’s determined by the need for care, by whether people know that they need care, by whether they want to obtain care and by whether care can be accessed.  

The primary goal of healthcare utilization is enhanced health status. As the Healthcare Financial Management Association (HFMA) notes, managing it involves the “integration of utilization review, risk management and quality assurance into management in order to ensure the judicious use of the facility's resources and high-quality care.” 

Factors that affect healthcare utilization include need, access, convenience, affordability, supply and demand, prevalence of chronic disease and sociodemographic population shifts. It often increases with the emergence of new technology and procedures, more health insurance coverage, changes in consumer preferences and the expanded use of existing drugs. Conversely, the utilization of healthcare services typically decreases with advances in public health, better understanding of disease risk factors, increased knowledge of prevention initiatives and the discovery and implementation of treatments that cure or eliminate diseases. 

Rapid Expansion of Telehealth 

It’s no surprise that healthcare utilization in many physician practices has decreased during the COVID-19 pandemic. According to FAIR Health, utilization of professional healthcare services fell almost 70 percent in April 2020 compared to the previous year. This drop has resulted in a 50 percent decline in revenue. 

The exception to this decrease is the use of digital platforms, specifically telehealth. As Epion COO Scott Freedman noted in a Physicians Practice article titled “Five things COVID is teaching us about the patient experience,” virtual care interactions were predicted to exceed 1 billion in 2020. 

Healthcare utilization via telehealth was surging before COVID-19 arrived on the scene and has soared since. The technology and IT infrastructure used for telehealth has advanced and become more streamlined, attracting younger Americans who have grown up with at-your-fingertips communication and expect quick service and access to results. 

Virtual care offers a practical option in a time when the deferral and elimination of care during the pandemic could prompt an estimated $575 billion net reduction in medical costs for healthcare payers. Even a year after the start of the COVID-19 outbreak, many healthcare consumers continue to voice trepidation about visiting their physician’s office for anything other than a serious injury or illness for fear of contracting the new coronavirus. 

Retrieval of Lost Practice Revenue 

Telehealth also offers a viable option for those without a primary care physician (PCP) and others who see healthcare as more of an on-demand service. A study from the Urgent Care Association found that a median of 35 percent of patients utilizing UCCs don’t have a PCP. 

For physician practices, telehealth offers a way to recoup some of the revenue lost during the pandemic while ensuring patients don’t forgo the care needed to protect their health. Plus, it seems as though most patients are more open to the technology than before the emergence of COVID-19. In a recent poll, two-thirds of respondents said the pandemic has increased their willingness to try telehealth. 

Overall, virtual care has the capability to be employed for coordination across care teams, patient portal connectivity and asynchronous data sharing. Practices can add another revenue stream while meeting patient demand for healthcare that is more accessible, affordable and convenient. 

Check out how Epion’s telehealth solution can help your practice deliver virtual care that feels personal, familiar and easy to use.