Group Well being Facilities’ Position in Delivering Care to the Nation’s Underserved Populations Through the Coronavirus Pandemic
Bradley Corallo,
Jennifer Tolbert, Sara Rosenbaum, Jessica Sharac, Peter Shin, and Charmi Trivedi
Revealed: Dec 23, 2020
Within the midst of the coronavirus pandemic, neighborhood well being facilities are serving as public well being responders, particularly for medically underserved populations. Well being facilities are a nationwide community of security web main care suppliers who supplied care to almost 30 million sufferers in 2019, and disproportionately serve sufferers who’re low-income, individuals of coloration, uninsured, or publicly insured – teams which have been particularly laborious hit by the pandemic. Primarily based on focus group interviews carried out in September and October 2020 with informants from 16 state and regional Main Care Associations (PCAs) representing 750 well being facilities and a supplemental questionnaire accomplished by PCAs following focus group interviews, this transient examines how well being facilities have tailored their service supply fashions in the course of the pandemic response and the present challenges they face persevering with to fulfill sufferers’ wants.
Key Findings
- Well being facilities are offering testing in underserved communities, however PCAs report there’s nonetheless unmet want. Within the week ending December 4th alone, well being facilities supplied over 335,000 checks. Respondents described a variety of efforts by well being facilities to extend testing capability, equivalent to testing in parking heaps, creating momentary testing websites, and deploying cellular testing models. Regardless of these efforts, among the collaborating PCAs stated that well being facilities of their state or area can’t present checks to all sufferers who want them, figuring out lengthy wait instances, shortages of PPE, and employees shortages as the most typical limitations to ample testing.
- Well being facilities are coordinating with state and native public well being companies on response efforts. Respondents reported that well being facilities of their states have been working with public officers to conduct testing and get in touch with tracing, safe reimbursement for telehealth visits, and guarantee entry to providers for susceptible populations. These efforts have helped present continued entry to care and have been necessary to well being facilities’ monetary stability.
- Quickly pivoting to telehealth was key for well being facilities to proceed seeing sufferers amid the pandemic and helped to maintain well being facilities financially solvent. Regardless of the success in shifting to telehealth providers, respondents famous each technological and cultural limitations for some sufferers. Whereas respondents agreed telehealth would possible stay an necessary service supply mode, additionally they described well being heart efforts to create safer environments for in-person care, equivalent to upgrading HVAC techniques and reconfiguring area for “sick” and “effectively” clinics.
- Many well being facilities are assembly sufferers “the place they’re” by taking medical care outdoors the clinic – whereas additionally addressing non-medical wants like meals insecurity. Respondents reported well being facilities’ use of cellular vans and different methods to succeed in agricultural staff the place they work and dwell, American Indian reservations, and different underserved communities hard-hit by the pandemic. Relying on the necessity, well being facilities are offering COVID-19 testing, handwashing stations, and flu immunizations, amongst different providers. Moreover, respondents described well being facilities partnering with native organizations to distribute meals and assess wants for housing and different social helps.
- Well being facilities face ongoing shortages of testing provides and PPE. Respondents reported that the competitors amongst hospitals and huge well being techniques for PPE usually made buying the provides harder. Many well being facilities have relied on consortia or PCAs for group shopping for energy, although PCAs indicated that well being facilities proceed going through issue getting ample testing provides and PPE.
- PCAs reported that employees layoffs as a result of pandemic have been comparatively restricted, however the pandemic’s impression on employees morale is a priority for the workforce and well being care accessibility. Most respondents reported that the size and uncertainty of the pandemic have been impacting employees morale. They famous a number of different components impacting morale, together with the difficult pivot to telehealth for employees offering providers which might be troublesome to carry out nearly, balancing work with obligations at dwelling as faculties moved on-line, and the ramifications of employees changing into contaminated with the coronavirus.
- Well being facilities are going through monetary uncertainty on a number of fronts following the drop in affected person quantity in the course of the pandemic. PCAs expressed considerations concerning the expiration of momentary provisions and authorizations associated to Medicaid protection and telehealth reimbursement when the general public well being emergency ends. They famous these provisions have been key to creating telehealth viable for well being heart funds in the course of the pandemic. Then again, Congress just lately voted to reauthorize federal funding for the Group Well being Heart Program ($5.7 billion in FY 2021) and, if signed into legislation, would add a lot wanted stability for well being facilities in the course of the pandemic, though monetary challenges stay going ahead.
- Questions stay about well being facilities’ function in administering a COVID-19 vaccine to medically underserved communities. A number of PCA respondents reported that well being facilities are concerned in vaccine distribution planning with states, however on the time of interviews, main questions remained about the place vaccines could be shipped and saved, how frontline well being heart employees could be immunized, whether or not employees ought to be deployed to state-run vaccination websites, and the way employees would monitor a number of doses of the vaccines. Most respondents additionally expressed the necessity for focused messaging to encourage sufferers to get the COVID-19 vaccine, particularly as a result of populations served by well being facilities could also be extra reluctant to get a vaccine as a result of distrust of the well being care system.
Well being facilities have made main diversifications to their service supply fashions to deal with well being care wants in probably the most susceptible communities in the course of the pandemic, however they nonetheless face many challenges. Most quick can be endeavor a large vaccination marketing campaign because the nation continues to battle with rising COVID-19 instances. Nonetheless, with the top of the pandemic doubtlessly in sight, shifting focus from the quick response to longer-term restoration will assist guarantee well being facilities stay in a position to look after traditionally underserved communities in the course of the pandemic and after its decision.