Their obvious overlap seems to indicate at least a partial solution to the problem that Massachusetts shares with most other states.
During the Massachusetts Association of Health Insurance Conference last week, Governor Charlie Baker said that due to chronic staff shortages, the health care industry needs to rethink the way it delivers services.
In October, Massachusetts Health & Hospital management estimated that community hospitals had about 19,000 full-time vacancies.
Staffing issues also affect health care payments, Baker said. Understaffed rehabilitation and long-term care facilities cannot take new patients from hospitals, leaving patients stranded while they wait for a place in their next care facility.
Tim Foley, executive vice president of 1199SEIU, which represents more than 70,000 healthcare professionals, said staffing shortages are a “system-wide problem” in hospitals, nursing homes, home care and other care facilities, which requires a “complete system solution.”
“Some of these jobs will not be replaced; we need to come together and think about new models of caregiving,” said Foley.
A feasibility study has just come out of one of these alternative care models, telehealth, which apparently was not discussed at that conference on Health Plans.
The use of telehealth as a regular method of care has illuminated the digital divide across socioeconomic lines, according to a new report from researchers and health care organizations.
As defined by the Health Resource Services Administration, telehealth uses electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health care administration.
Realizing the long-standing health inequalities that the COVID-19 pandemic has brought to light, the Massachusetts Health Insurance Association initiated the study early in the pandemic to research uneven acceptance of telehealth use, said vice president of MAHP advocacy and engagement, Elizabeth Leahy.
Researchers concluded that the state’s oldest and youngest residents visit the physician in person more often, as do low-income, minority, and rural populations, after analyzing data from 1.8 million health plan members from January 2019 to December 2021.
Nathalie McIntosh, senior director of programs and research at Massachusetts Health Quality Partners, said that for seniors, low telehealth use could be caused by a combination of technological barriers and the routine and comfort of visiting the doctor in person.
The researchers spoke to some people — including seniors and English learners — who don’t own a cellphone or, if they do, don’t know how to use the video feature, McIntosh said. “The phone visits were really helpful” for these populations, she said.
For younger adults who don’t use telehealth, McIntosh said this isn’t a digital literacy issue, but rather an indicator of limited access to primary care providers in general.
“To do a telehealth appointment, you really need to have a regular care source, because it’s a scheduled appointment,” she said.
Regionally, telehealth use was highest in greater Boston and other densely populated areas of eastern Massachusetts, and lowest in central and western Massachusetts – except for some cities and towns in the Pioneer Valley, where telehealth accounted for more than 43% of visits. .
An encouraging development that offers a possible solution to the general shortage of health professionals, telehealth has been used extensively statewide for behavioral health care, with an average of 75 to 80% of all mental health visits conducted virtually every every month.
This high percentage likely reflects recent improvements in reimbursement as a result of a law signed by the governor in January 2021 that required permanent payment parity for remote mental health services.
Focusing on ways to increase telehealth services among young adults without access to a primary care physician, older patients, and those with socioeconomic challenges could significantly fill this healthcare staffing gap.
For the MAHP/Harvard study, researchers recommended that health plans improve screening for digital accessibility and simplify enrollment in underutilized public benefit programs to make the internet and devices more accessible, as well as build referral partnerships with community organizations who can provide digital literacy training.
As our governor and former CEO of Harvard Pilgrim Health Care warned, the medical industry may never return to its pre-pandemic state.
It may not be a panacea, but encouraging telehealth as a way to offset the likelihood of permanent staff shortages would be penicillin for this chronic condition.