By TONY COWAN

As COVID-19 and its mutations continue to criss-cross the globe, medical practices and public health workers have dealt with alternating medical surge events and empty exam rooms. This has caused both an increase in healthcare costs and a dramatic reduction in typical healthcare reimbursements. As the COVID-19 focus pivots from response to recovery, medical practices will need to start generating new revenue as they work to better understand and care for what NIH is calling COVID-19 Syndrome. It is now well known that the consequences of becoming infected by the virus caused by SARS-CoV-2 has the potential of causing long-term health issues. Practices that set themselves up to identify these issues prior to them becoming chronic will be critical to keeping treatment costs down. As reported by Justine Coleman (2021), during a hearing for a House Energy and Commerce subcommittee, NIH Director Francis Collins cited preliminary research that found ten percent to thirty percent of people who had COVID-19 may develop long-term health issues. With more than 34 million confirmed cases in the U.S. in the past year, that could amount to millions dealing with COVID-19 for some time to come.

“Some of you have been suffering for more than a year, with no answers, no treatment options, not even a forecast of what your future may hold,” Director Francis said. “Some of you have even faced skepticism about whether your symptoms are real. I want to assure you that we at NIH hear you and believe you” (Coleman, 2021).

A significant opportunity for new reimbursable tests exists for medical practices across the country if they embrace new diagnostic options that will help detect presymptomatic issues and keep lower-cost treatment options open. This is the ideal match where both quality care and new revenue streams come together.

The question ‘Do you ever fully recover from COVID-19?’ is terrifying and needs to be answered. Dr Phil Mongelluzzo, Jr., the Chief Medical Officer with the medical device company that conducts pre-symptomatic screenings called Pulse4Pulse™ said, “We already know of ongoing complications of COVID-19 including, a systemic inflammatory response that at the current time is unknown in duration and has widespread effects on multiple organ systems. COVID-19 causes disruption of the microvascular system and the systems that maintain balance in our bodies. We need to implement a tracking system and fortunately Pulse4Pulse™ can define and identify endothelial dysfunction (smallest blood vessel disease in our bodies) and autonomic dysfunction (an alteration in our body’s ability to maintain balance. The importance of this cannot be understated – our bodies are amazing at maintaining order and we do not become symptomatic until it is too far along in the process. We need to know about issues while they are still asymptomatic” (Mongelluzzo, Jr., 2021).

Dr, Mongelluzzo’s point is magnified by a recent article in the Cardiac Failure Review “Mechanisms Underlying the Occurrence” (Montone, R.A., et. al., 2020). This graphic from that article helps illustrate the current connections from the viruses to the complications arising from it.

The ability to capture pre-symptomatic evidence of these diseases creates the ability to address them with lower-cost prescriptions and treatment. This is great for the patient and great for keeping healthcare costs down. The Centers for Medicare & Medicaid Services already knows this because they have set up the Primary Care First Model Options (2021). They are literally rewarding the PCP who can capture and track the early diagnosis of pre-symptomatic issues that identify a compromised health profile (Centers for Medicare & Medicaid Services, 2021). There is real value in capturing the patient’s current health profile and tracking pre-symptomatic issues that, when not identified or treated, become chronic long term expensive treatments. This prioritizes both the patient, by emphasizing the doctor-patient relationship to keep the patient healthy, and saving money over the long term while increasing per visit reimbursements.

With Medicare compensating practices for catching presymptomatic issues before they evolve, the same pandemic that kept patients out of exam rooms could bring them back. The focus of the work now is to figure out how to mitigate the health complications of COVID-19 on a long-term or, as it is being called by the CDC, Long Covid (Centers for Disease Control and Prevention, 2021). This work is going to require a better solution than a medical practice having to wait until the patient presents with advanced symptoms of a disease they could have diagnosed in the earliest stages.

Tony Cowan is the Administrative Director at www.weareibec.org a consortium of scientists, agencies and industries tackling the challenge of striving in the new normal, post lessons-learned from COVID-19. He has over twenty years of healthcare development experience and deployed the first FEMA Category “B” funded clinics to become licensed healthcare facilities after a disaster, supporting medical public health infrastructure long-term. He is also the Director of Emergency Response Technologies with www.Clinicsonwheels.com where they designed, manufactured, and deployed the first Cares Act eligible, mobile vaccine distribution unit for Seminole County, Florida.

References

Centers for Disease Control and Prevention. (2021, April 8). Long-term effects. Retrieved from CDC.gov: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html

Centers for Medicare & Medicaid Services. (2021, April 6). Primary Care First Model Options. Retrieved from CMS.gov: https://innovation.cms.gov/innovation-models/primary-care-first-model-options

Coleman, J. (2021, April 28). NIH readies grants for more research on long-term health effects of COVID-19. Retrieved from TheHill.com: https://thehill.com/policy/healthcare/550783-nih-readies-grants-for-more-research-on-long-covid-19

Mongelluzo, Jr., P. (2021, February 2). Chief Medical Officer, Pulse4Pulse. (T. Cowan, Interviewer)

Montone, R.A., Iannaccone, G., Meucci, M.C., Gurgoglione, F., & Niccoli, G. (2020). Mechanisms underlying the occurrence. European Cardiology Review 2020; 15:e52, https://doi.org/10.15420/ecr.2020.22.