By Brianna Zink, RN, MSN
1,154 days after the COVID-19 Public Health Emergency (PHE) was first declared, it will come to an end. While this is not necessarily a surprise, there are some surprising elements to this that will likely have lasting impacts on healthcare in the US. Much uncertainty lies ahead in regard to the number of individuals that will lose coverage, the extent to which the landscape of care delivery will be permanently altered, and what other elements of this new normal are now here to stay.
The American Hospital Association estimates that up to 15 million Americans will lose coverage as states resume Medicaid redeterminations and possibly unenrollment, which have not been performed since the PHE was declared on March 13, 2020. According to a survey completed in December 2022, when many assumed the PHE would come to an end in April rather than extending an additional month, 64% of adults in a Medicaid-enrolled family were not aware about the return to a regular Medicaid renewal process. The impact this will have on hospitals will likely hit harder for regional or rural hospitals and those in areas with high levels of poverty. Historically, 65% of individuals who lose Medicaid coverage spend a period of time without any coverage, according to studies prior to the pandemic by the Kaiser Family Foundation. During a period when hospital margins are tighter than ever and sometimes negative, this may add additional stressors. However, the end of the PHE does illustrate the progress that has been made in fighting the illness and some who may still be reluctant to seek medical care for unrelated diseases and illness may begin to feel safe enough to seek the care they require.
A silver lining of the COVID-19 pandemic was the pace of innovation in healthcare and the speed of adoption of new or improved processes and technologies. Many of the changes that the PHE provided for telehealth services have been extended through calendar year 2024. Estimates on the increased use of telehealth during the pandemic compared to before vary between specialties, generations, geographic location, and even types of diseases and illness. However, all agree that the use of telehealth increased quickly and drastically as a result of the pandemic, and it seems to be something that is here to stay.
Within the hospital walls we have also seen many changes that were either spurred or fueled by the pandemic. Virtual nursing, which I would argue may have its roots in telehealth concepts, is making a rise as an efficient way to ensure patients receive timely, quality care and to offer nurses flexibility in their work and ultimately reduce burnout and attrition. Virtual nursing allows for a single nurse to remotely monitor patients and aid in their care for all things that can be done virtually. This is proving to lighten the workload for nurses and other caregivers at the bedside while also providing more flexible work options for nurses. While the end of the PHE may not directly impact virtual nursing, it seems to have allowed for some flexibilities and forced innovation that may have lasting impacts on the field of nursing.
Since the announcement on January 30, 2023 about the COVID-19 Public Health Emergency coming to an end, I’ve asked many nursing leaders how they are preparing or how this impacts them. The overwhelming response is that they aren’t focused on the end, but rather the changes, both good and bad, that the PHE and the pandemic itself created. The pandemic threw the healthcare industry into a period where innovation occurred faster than ever – now will be the time to look at the massive amounts of data created by this innovation and determine which innovations provide the most benefit and should be carried forward into this new normal we have all been waiting 1,154 days for.
Brianna Zink, RN, MSN is the Senior Director of Product Strategy for Healthcare at Infor, where her work is focused on helping healthcare organizations and providers achieve success in evolving markets through the successful utilization of technology.