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Industry Trends

Healthcare Trends You Should Not Ignore

We asked our healthcare industry practice leaders what they are seeing related to business challenges, claims development and risk management. The consensus? It’s not all good, but it’s not all bad.

May 4, 2021

BUSINESS CHALLENGES From Tammy Kraatz, Director – Workers’ Compensation Underwriting

In 2020, many healthcare entities were forced to put several basic services and procedures on hold to protect patients and employees from COVID-19. These services and procedures are a significant revenue source, forcing many healthcare entities to layoff, furlough or reduce pay to staff.

Larger healthcare operations had better access to personal protective equipment (PPE) and seemed to have an easier experience being approved for CARES Act funding. We expect these larger systems should bounce back financially.

On the other hand, many smaller regional systems were already experiencing financial pressures before COVID-19 and continued to struggle. They had supply issues and, in some cases, found it more difficult to get federal funding. They might not be able to recover financially and may look to be acquired or affiliated with a larger healthcare organization in the future. Expect to see mergers well into 2021 and beyond for this industry.

CLAIMS TRENDS From Stacy Whalen – Senior Medical Manager

Healthcare employers have seen an overall decrease in catastrophic workers’ compensation claims this year, but unlike other industries, their workers have experienced the highest rate of COVID positive claims, the highest rate of hospitalizations and the highest percentage of COVID-related death claims. Where there was a drop in one area, there was a surge in the other.

Because of the number of COVID claims in healthcare, the industry is expected to incur a high proportion of claims with unknown exposure. We are just beginning to learn the secondary effects of the disease such as weakness, heart and lung involvement, nerve damage and, in the most severe cases, loss of limbs and organ transplants. These secondary effects invite the potential for claims to remain open for long-term treatment, which tend to be the claims that become more challenging over time.

We have learned a lot over the past year about the costs associated with COVID hospitalization and the care of healthcare workers – with some claims reaching over $1 million in less than a year since the pandemic began.

Keep a close eye on these healthcare claims trends because they are likely to affect some long-term changes in healthcare delivery.

RISK MANAGEMENT From Maryann Hoff – Senior Risk Control Manager

The pandemic enhanced the risk management alignment of patient and employee safety. Healthcare safety and risk managers continue to improve ways to make the industry safe and protect healthcare workers and patients. Identifying hazards and exposures in the workplace, and aggregating that data to have real-time impact on the challenges that are being faced, is increasing the healthcare industry’s adoption of technologies that digitize their safety programs. From hazard identification to incident analyses, healthcare institutions are implementing these technologies to help them improve their safety programs.

Concurrently, these innovations are helping to mitigate workplace violence exposure through enhanced communication practices with patients and their families, feedback surveys and increased protocols limiting unauthorized access. Facility security measures are also being improved, aimed at reducing on-site exposures.

Finally, increased emphasis on safety and personal protective equipment has also impacted how and when healthcare employees use protective equipment while providing care in addition to other workplace safety practices.

TELEHEALTH From Alleen Wilson – Senior Risk Control Manager

Telehealth has proven to gain momentum in the way healthcare is delivered and will surely remain as a permanent service far beyond the resolution of COVID-19.

Hospitals and healthcare facilities alike turned to telehealth to continue patient visits when stay-at-home orders were implemented. Though telehealth was practiced before the pandemic, it did not have near the same level of use as today. Reports say that the industry has seen 50 – 175 times the number of patients via telehealth than prior to the pandemic.

Telehealth is not going anywhere anytime soon due to some significant advantages. First, it provides ease of physician access, which is a major challenge for those that live in remote areas and can now benefit from easier and quicker access to medical specialists. Second, it is convenient for everyone. Virtual visits offer patients simple on-demand care without the time and cost of most office visits. Third, it increases patient engagement, helping patients maintain visits and care plans. It makes it easier to conduct follow-up appointments, report concerns promptly and reach out with questions. Finally, it increases the quality and timeliness of care, which helps patients address concerns more quickly.