Healthcare rebounds in some sectors, according to Rand report

Pandemic Patterns

While screenings for breast and colon cancer went way down at the beginning of the COVID-19 pandemic, they were back up by the end of July, according to a Rand, Harvard Medical School and Castlight Health report published in the Journal of General Internal Medicine that scrutinized the private insurance claims of 6.8 million people from 45 to 64, reported Samantha Liss in Healthcare Dive. (https://www.healthcaredive.com/news/cancer-screenings-bounced-back-after-steep-pandemic-declines-rand-report-s/597172/?utm_source=Sailthru&utm_medium=email&utm_campaign=Newsletter%20Weekly%20Roundup:%20Healthcare%20Dive:%20Daily%20Dive%2003-27-2021&utm_term=Healthcare%20Dive%20Weekender)

The report said that the rate of women wanting mammograms was higher by the end of July than in the months prior to the pandemic when the median weekly rate of mammogram screenings was 87.8 women per 10,000 beneficiaries. It went up to 88.2 screenings per 10,000 beneficiaries by the end of July, but the rate of colonoscopies only returned to near normal, said the researchers. Before the crisis, median weekly colonoscopy rates were 15.1 per 10,000 beneficiaries and then came back to 12.6 per 10,000 beneficiaries.

Liss explained that the fallout from the pandemic has caused serious concerns “about the long-term health consequences for Americans as they delayed care either due to pandemic-related restrictions or their own fears about returning to in-person care.” In an attempt to have enough space to accommodate COVID patients or keep cases at bay, many healthcare facilities in the U.S. closed down many of their facilities for months. Hospitals that stopped elective procedures lost $20 billion in care not delivered. As these facilities reopened, healthcare leaders talked about depressed patient volumes, making the country concerned about the long-term health prospects for patients. In the case of cancer, early detection and intervention leads to improved outcomes.

Liss believes that the report may ease some of those worries. Adult patients returned for screenings even with a surge of cases in the summer in some areas.

According to Ryan McBain, lead author and policy researcher at Rand, "These are the first findings to show that, despite real fears about the consequences of drop-off in cancer screens, health facilities figured out how to pick this back up after the initial pandemic restrictions." Medical claims data from Castlight, a health benefits manager for employer-sponsored plans, show cancer screenings for breast cancer and colonoscopies decreased hugely in April, falling 96 and 95 percent. The rate of decline for colonoscopies was higher in high-income counties, but there were no significant demographic trends in the rates of mammograms.

Liss pointed out that there are limitations to this research. She explained that the report fails to include data for the uninsured or those with public plans such as Medicare or Medicaid and does not take into account alternate forms of colorectal cancer screenings such as FOBT, or fecal occult blood tests, which test stool samples.

Researchers have been studying patient volume trends in 2020 as more data are obtained. A Commonwealth Fund report showed that outpatient visits held steady in the last month of 2020 when there was another surge in cases, but trends varied by age group. Pediatric offices showed the steepest decline, but visits to certain specialists increased over pre-pandemic levels.