Experts discuss the effects of the pandemic on Michigan patients, hospitals and care centers

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Throughout the COVID-19 pandemic, Michigan’s emergency department (ED) and primary care utilization has dropped significantly, according to representatives of those facilities. This has resulted in shrinking operating margins for healthcare centers and deteriorating patient health across the state.

A lap 2022 State of Michigan Reform Health Policy Conferencea panel of three experts from different healthcare delivery silos spoke about the effect COVID-19 has had on hospitals and patients across the state who have postponed important medical care.

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Nina Abubakari, president and CEO of Advantage Health Centers, Darryl Elmouchi, president of BHSH/Spectrum Health West Michigan, and Christine Surdock, president of Plan de Molina Healthcare Michigan, spoke on the panel.

The three presenters shared data points showing the decline in services and significant precautionary screenings being given in the state.

Elmouchi said that at the end of 2020, there was 42% less emergency care provided in BHSH hospitals, including 23% fewer emergency room visits for heart attacks.

“It not only had ramifications at the time, but will have lasting ramifications for public health — and the health of health care systems — in the months and years to come,” Elmouchi said.

BHSH hospitals have also been heavily impacted by the recent omicron wave. Elmouchi said more than 2,000 elective surgeries were canceled during the omicron wave alone, leading to more delayed care and people not getting the treatment they need.

Abubakari spoke about his experience at Advantage, a Federally Qualified Health Center (FQHC) in Detroit. At Advantage, she saw a higher number of positive rates for COVID-19 accompanied by 43% fewer in-person visits. Although the center moved to telehealth care, not all patients had access to the technology needed to receive virtual care.

Advantage has seen a significant drop in the use of dental services, cervical cancer screenings, counselling, depression screenings and follow-up, high blood pressure control, diabetic treatment, HIV testing and diagnostics, among others.

“As you can imagine, with the reduction in the number of patients we saw and our inability to deliver telehealth effectively and efficiently, the care we provided was not as robust, comprehensive and certainly not as integrated. that we could once do. Abubakari said. “It certainly had an effect on our ability to provide quality care to our patients.”

Surdock spoke specifically about Molina’s Medicaid members and how they’ve been impacted by COVID-19. Over the two years of the pandemic, their members have seen an 8% decrease in breast cancer screenings, a 20% decrease in well-child visits in a child’s first 15 months, a 35% drop in childhood immunizations, and a 24% drop in child lead screening.

Panelists then talked more about how the pandemic has affected the health of hospitals, health systems, FQHCs and primary care providers. The pandemic has resulted in lower revenues and lower morale in healthcare delivery spaces.

Elmouchi said the average hospital at the start of 2022 had a negative operating margin of 3.5% to 4.5%. This is due to the reduced amount of more expensive services like elective surgeries.

“This is going to have a dramatic impact on how we are all able to take care of people,” Elmouchi said.

Due to declining operating margins, many state hospitals and health centers have had to close. Abubakari said 17% of health centers are temporarily closed and 33% of community health centers in the state are closed at least temporarily.

She said that although the federal government and state governments have received a lot of money to supplement these lost revenues for health centers, patient visits remain the main driver of revenue.

“When you see this reduction in the number of patients, you are also going to see a reduction in revenue,” Abubakari said.

Panelists also spoke about the increase in workplace stress and violence experienced by healthcare professionals.

Elmouchi pointed out that violence against healthcare workers, particularly due to the enforcement of mask mandates in hospitals and primary care settings, is three times higher than before the pandemic.

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