Video & highlights from “5 Slides: Responding to COVID-19 in Arizona”

This past Thursday we held our “5 Slides: Responding to COVID-19 in Arizona” virtual convening. 

The conversation featured Lorry Bottrill, President/CEO, MercyCare of Arizona, Marcus Johnson, Director of State Health Policy and Advocacy, Vitalyst Health Foundation, and Mo Sheldon, CEO, Northern Cochise Community Hospital. State of Reform publisher, DJ Wilson, moderated the conversation 

During the conversation, the three leaders discussed how they have been navigating through organizational challenges both operationally and financially, in responding to the COVID-19 crisis. 

 

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Wilson kicked off the conversation with a slide about the protests of the last two weeks which have gripped the nation. He asked each panelist how they were thinking about the protests and how their organizations might respond.

Bottrill began by saying that Mercy Care is engaging in a period of listening, learning, and reflection of how they can impact the community. Going forward, Bottrill said Mercy Care would also be thinking about health equity, inclusion, training, and how to forge partnerships within the community that extend beyond the immediate future. 

Sheldon confirmed that as of last week, demonstrations were moving into rural Arizona. In addition to underscoring the points made by Bottrill regarding the importance of prioritizing health equity, inclusion, and training, Sheldon said providers should look even further. 

I think it’s our responsibility to look further into the community and look at how we can help other community organizations develop plans to move forward with health equity.”

Johnson rounded out this portion of the conversation by emphasizing the importance of keeping an eye on data to come up with actionable solutions. To do so at Vitalyst, Johnson said, the organization has taken steps to develop a language for having conversations about race and looking at disparities through a racial lens. 

Transitioning to the COVID-19 portion of the conversation, Bottrill teed up a slide on the transformation of care delivery through telehealth.

 

 

Bottrill noted that Mercy Care’s data, as expected, saw a striking increase in the utilization of telehealth services. Growth in telehealth services as percentage of paid claims experienced a significant uptick in April. Bottrill continued by noting the importance of being mindful of the idea that, while the implementation of telehealth poses new opportunities for delivery systems, the rate at which patients become comfortable with telehealth might differ from person to person.

On telehealth, Sheldon offered data points on telehealth visits at the rural Northern Cochise Community Hospital. In April, 17% of primary care visits were conducted via telehealth. In May that figure came down to 3%. The jury is still out on whether that downturn is an anomaly or related to the status of the virus. The relaxation of Medicare rules with respect to telehealth also allowed for increased implementation. 

Moving on Johnson’s slide, the conversation shifted to access to health insurance coverage in Arizona.

We know that Medicaid is a counter-cyclical program. Anytime that the economy dips Medicaid enrollment goes up.”

 

 

Unemployment claims in Arizona have skyrocketed, as expected. We would also expect that due to the nature of employment being tied to health insurance coverage in the United States, that health insurance would be lost by a lot of people and people would be out there looking for new sorts of insurance coverage. We are not seeing that with Medicaid enrollment right now.”

As displayed on the graph, while unemployment claims have skyrocketed, new AHCCCS applications have flatlined. 

Johnson pointed out the National Association of Medicaid Directors has indicated that this is a national trend. Several states have seen a delayed potential uptick for access enrollment. When asked for his hypothesis on the conundrum, Johnson discussed a “Maslow’s Hierarchy of Needs,” of sorts.

When people lose their jobs, people might be filing for unemployment, sign up for SNAP benefits, etc, before they begin to think about insurance. The result is a delayed onset. The panel anticipated that even if delayed, the uptick will occur eventually. 

Shifting away from data, Sheldon’s slide concern the increased need in health care teams to relate with each other differently.

 

 

Dealing with a shortage of PPE and the exposure to rapid deterioration of patients, providers felt the weight of the health care system’s demands. Nevertheless, Sheldon said the challenging circumstances forced team members to be innovative, such as creating a safer way for staff to intubate patients (a high risk activity for the spread of COVID-19).

The full video of the conversation is available here.