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Covid-19 is shifting care out of the hospital. Here's what that means for 3 key service lines.

By Sarah AdamSarabel ComtoisAndrea Hendrickson

February 23, 2021

    As fear over Covid-19 exposure endures among patients, the shift to alternate sites of care outside the hospital has accelerated.

    Underlying this trend are several compounding factors. Economic instability, for example, will advance site-of-care shifts in 2021 as price sensitivity among patients increases. Meanwhile, CMS rules, such as the removal of the IPO list, have opened more opportunities for steerage, and payers and employers will likely capitalize on these headwinds in pursuit of cost-saving opportunities. 

    As a result, a site-of-care strategy should be top of mind for service line leaders in 2021. While specialty telehealth will likely be a part of that strategy, our analysis below focuses solely on shifts between facilities in three key service lines: women's health, orthopedics and spine, and oncology. 

    Women's Health

    Traditionally, women have chosen where to receive pregnancy care based on quality, access, and reputation. However, Covid-19 has altered patient preferences and driven women to seek out-of-hospital care for a few reasons. First, women are opting for virtual visits to protect both themselves and their newborns. Second, restrictions on the number of visitors allowed during birth have led more women to consider alternative birthing options, such as freestanding birthing centers and home births.  

    Women's programs should ensure their 2021 strategies include a robust telehealth program and alternative birthing options. We have resources to guide you on both, including a pregnancy care telehealth primer and tactics for launching midwifery services


    Orthopedic procedures had already experienced a shift to the outpatient setting before the Covid-19 pandemic hit. According to our latest orthopedic consumer survey, 78% of orthopedic patients would choose to have surgery at an ambulatory surgery center (ASC) for $1,300 less than in the hospital outpatient (HOPD) setting. The recent regulatory changes allowing providers to perform joint replacement and spinal procedures in HOPDs and ASCs for Medicare patients will further drive this trend. However, the cancelation of elective surgeries has caused a decrease in volumes in the outpatient setting.

    As orthopedic programs try to boost volumes, elective surgery volumes are crucial to recover and retain. Working through the backlog will depend on which reopening phase each orthopedic surgery falls into and require flexible staff capacity as well as expanded OR and procedure room hours. Read through our 2021 orthopedic market trends for more information on how to steer your program for success throughout the year.


    While oncology has long been an outpatient business, Covid-19 has still created unique challenges for patient volumes. Cancer programs report drops in screenings and, consequently, diagnoses, which threaten a worrying trend toward higher acuity patients down the line.

    Oncology leaders must plan now for how to get ahead of the eventual influx of volumes. One tactic is to create a safe and welcoming environment for your patients. Read this blog to learn how other cancer programs are doing this effectively, and learn how some organizations have accelerated their provision of oncology infusions in the home to help select patients stay safe. You can also join our upcoming webinar for further insight into Covid-19's impact on oncology care.

    The oncology market trends you need to know for 2021


    After a tumultuous year, planners will need to return to pre-pandemic priorities, recognize and respond to new market disruptions, and find creative ways to drive oncology capture—all while managing the continued fallout of Covid-19.

    Tune into our webinar on March 24 at 3 p.m. ET to learn about the most important trends and their impact on your oncology strategy.

    Register Now


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