Learnings from COVID-19 must drive major changes in health care delivery, according to interviews conducted with physician leaders of the nation’s leading multi-specialty medical groups and health systems that participate in the Council of Accountable Physician Practices (CAPP). CAPP includes more than 30 groups representing more than 85,000 physicians.

“It’s clear that the investments made by integrated medical groups in telehealth, population health, physician leadership, and coordinated care paid off in the COVID-19 crisis,” noted Laura Fegraus, executive director of CAPP. “Our groups were able to quickly transition the vast majority of patient visits from in-person to remote. We leveraged existing programs to care for high-risk patients and relied on our strong culture of teamwork to maintain continuity of care during the crisis. It is this ‘systemness’ that was behind our ability to respond to the pandemic, and it is this ‘systemness’ that must be expanded to improve health care for everyone.”

Other examples of the benefits of these systems include the rapid formation of operational command centers, multiple daily briefings, real-time communications about changes to treatment protocols, and immediately encoding new best treatment practices into electronic health IT systems.

Going forward, these physician leaders do not see a return to “normal.”

“In this pandemic, we are learning just how innovative and resilient we can be when these restrictions are removed. It’s our hope that we will not waste this crisis and its learnings, and that we can move forward together to reshape our system for the better.”

The physician leaders cited six major initiatives that should be encouraged to shape the health care system post-COVID.

1. Accelerate the Transition to Paying for Value. When providers are paid for value and not volume, they can focus solely on the benefit to their patients. They can innovate rapidly to improve outcomes, the patient experience, and bend the cost curve. Medical groups and health systems that provided care in value-based payment models had a more stable financial base, allowing them to weather the financial impact of the pandemic and meet their patients’ needs in this crisis.
2. Remote Care Is Here to Stay. Remote patient visits should be sustained with regulatory support and payment on a parity with in-person visits. Remote visits can be safer for patients and providers, and are often more convenient. Telehealth also solves many of the access issues that exist due to distance, shortages of health care providers, and other barriers. The pandemic is demonstrating that telehealth now has a value proposition that exceeds convenience.
3. Health Care Is Moving Home. The location of care is shifting from brick-and-mortar facilities to the home. Home treatment for many patients can be safer, more convenient, less expensive, and more desirable. Patients with chronic illnesses should have access to home-monitoring equipment, when clinically appropriate, that keeps their physicians and care teams informed of their condition. New initiatives such as hospital-at-home should be further explored and developed.
4. Invest in Primary Care and Prevention. Many physician practices have taken significant financial hits during the pandemic. Going forward, physicians should benefit from the support of an integrated infrastructure in order to deliver the best care in today’s complex delivery system. Better models of care and payment will help them fulfill their patient care mission and stay in business.
5. Stakeholder Collaboration to Remedy Health Care Disparities.  Policymakers, health care providers and purchasers must collaborate to fundamentally address health disparities, which have once again been highlighted by the pandemic.
6. Bring Physician Leaders to the Table. Accountable physician leaders should be involved in the planning and design of the next evolutionary phase of American health care. They should be treated as experienced engineers of care delivery who ensure that the focus always remains on the patient.

“It’s time to bring to bear the learnings of this challenging time and make a plan that will fast-track us to the ultimate goal: a healthy America,” concluded Stephen Parodi, MD, chair of CAPP and executive vice president of External Affairs, Communications and Brand, The Permanente Federation.

For more information, read “COVID-19 Lessons: A Path to a Better Healthcare System”.