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Projection: the shift of health care from hospital settings will continue

According to a new report from health care analysts at Sg2, the post-pandemic period will show a decline in hospital patient volumes. By the year 2029, services for non-hospital outpatients are expected to increase by 19 percent, with ambulatory surgical centers showing growth of 25 percent while inpatient discharge volumes overall are expected to decline by 1 percent over the same time period. 

The pandemic brought new care models and site of care shifts driven by clinical necessity, which should forever change where care is delivered. The growth in outpatient surgeries will be driven by changing practice patterns that occurred during the pandemic as well as other changes such as the elimination of the CMS Inpatient Only (IPO) restrictions and the growing proliferation of minimally invasive procedures. 

Sg2 reports that emergency department (ED) visits remained sharply down in 2020, a 20 percent decline from 2019. While consumer reticence to visit hospital emergency departments was at a peak during the COVID-19 pandemic, the shift to alternative care sites for low-acuity conditions was well underway prior to the pandemic. Beginning in 2017, national ED volumes remained flat, and low-acuity urgent visits declined.

Most interesting was the commentary about the prevalence and possible longevity of telehealth for various service lines. Virtual visit use increased dramatically in 2020, but even as in-person visits returned in the fall and winter, sustained adoption of virtual health continues in some specialty areas such as behavioral health. 

Overall, evaluation and management (E&M) visits are projected to grow 14 percent over the decade, with 29% of "office visits" expected to be performed via telehealth by 2029. As a result, in-person visits are forecasted to decline by 19 percent. Advances made in digital infrastructure, remote monitoring and diagnostics, and payment policies during the pandemic have led to enduring care delivery changes to not only virtual visits but also home diagnostics, infusions, physical therapy, and services that allow patients to be cared for in the home in place of the hospital, hospital outpatient department (HOPD), or post-acute settings.

I believe the projections from Sg2 for movement of health services from acute hospital to ambulatory settings are well founded. This trend will be fascinating to watch.

Overall, outpatient volumes are projected to reach and surpass 2019 volumes during 2022 and grow slightly above population estimated growth over the decade. Expanded insurance coverage (exchanges and Medicaid), an aging population and the rise in chronic disease are the main drivers of growth.

Tags

health care & life sciences, outpatient, telehealth, post-pandemic

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