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Blog
The COVID-19 Effect on Elective Procedures
Utilizing external data to address the changing paradigm in elective care
Mar 16, 2021
When COVID-19 began, it took a huge toll on elective procedures. Data from IQVIA shows that when the pandemic began last spring in the U.S., virtually every category of elective procedures saw initial dramatic decreases. Ophthalmic procedures fell 94% compared with pre-pandemic figures, pain-related procedures dropped by 91%, and orthopedic procedures fell by almost half.
Despite slow recovery in procedure volume into the summer months, and the accelerated recovery in the fall, this cumulative decrease of elective surgeries has resulted in a significant revenue loss for providers who rely on these types of procedures to drive profitability. On the other end of the spectrum, payers initially recognized the financial benefit of avoiding the cost of covering elective surgeries during the pandemic, but now face uncertainty about how pent-up demand will affect utilization and their bottom line in the coming years.
For both stakeholder groups, the impact COVID-19 has had on elective surgeries and uncertainty about the future is creating significant financial risk. Will payers cover as many elective procedures in the years to come? Will providers respond by shifting resources and finding profitability in other non-elective service lines? Both groups will need new, enhanced analytics to better manage and mitigate these risks.
In the past, both stakeholder groups could rely on their own historic data to predict future monthly and seasonal demand for elective procedures and plan accordingly. However, the lack of experience with COVID-19 – or any global pandemic – means that they won’t have the information they need to forecast future trends, revenue expectations, or related costs.
This lack of data complicates the strategic planning process for both payers and providers and puts their financial viability and long-term strategy at risk.
Another source of knowledge
When payers and providers utilize broader market insights gained from external datasets, like IQVIA’s Medical Claims Database, and combine it with other internal and public sources, they can more accurately forecast future trends and how COVID-related changes in elective care will impact their operations.
The IQVIA Medical Claims Database contains 1.1B annual claims, offering users vital information about what takes place during patient visits with their physicians. The data covers patient-level diagnoses, procedures, and in-office treatments for visits made across medical practices, hospitals, ambulatory surgical centers, and other healthcare practices. It also includes demographic, treatment, care and physician information, including patient geography, as well as dates and types of locations where care was delivered.
One of the greatest benefits of IQVIA’s Medical Claims Database for strategic planning and market assessment is its timeliness. Because it is an open source database, users can see most medical claims within 7 to 21 days of submission. This makes it ideal for anticipating demand, assessing market opportunities, and monitoring procedure trends.
Payers and providers can use the data to monitor upticks in elective procedures and to analyze trends across regions, patient populations, procedure types, and other criteria.
Local and regional insights allow providers to proactively position their services, staff, facilities, and marketing messages to make the most of the variable return to normal volumes. Payers can use it to adapt their offerings and support services to mitigate costs while continuing to ensure the best care for their members.
Expert guidance
Payers and providers can gain further clarity by reviewing the webinars, whitepapers, and related content developed by IQVIA experts, like those at the IQVIA Institute of Human Data Science. Our experts proactively monitor these trends in order to get a national perspective on which procedures are rebounding, and which ones will be slower to recover. It is still unclear when elective procedures will return to normal and which procedures will be first to recover given pent-up demand, but with diverse data sets, it paints a clearer picture when forecasting future trends.
The loss of revenue from elective procedures has been a considerable financial burden for providers during the pandemic in the short-term but has assisted payers in reassessing truly elective procedures and reducing healthcare spend. However, it also serves as a catalyst for both to reconfigure the delivery of healthcare services based upon new market trends. It may still be several months before we see exactly how the elective procedure landscape will evolve, but if organizations leverage these data now, they will be better prepared to capitalize on future opportunities and mitigate risk.
Healthcare expertise & unparalleled data to mitigate risk
Learn how using trusted external analytics, combined with insights from your own data, can mitigate risk and support your strategic planning process.