COVID changed health care needs and how they are delivered

Wellness in the workplace has always been about encouraging healthy diets, exercise and overall care of the body. 

But the COVID pandemic has shown that is it much more. 

David Swift, senior vice president and chief human resource officer, Penn State Health, told a gathering of health care and insurance professionals Tuesday at the Central Penn Business Journal Health Care Summit in Harrisburg that companies need to think about wellness differently, “through a different lens.” 

The state of virtual health care and the mental and behavioral health care crisis were also addressed during the morning-long summit attended by about 80 professionals. 

Swift outlined eight dimensions of wellness for business leaders to consider. Physical wellness, which he said has long been a consideration, encourages employees to take care of their physical well-being.  

But that’s just the start, he said. Social wellness, meaning connection, took a spotlight when everyone was working remotely. “COVID’s impact more than anything showed the importance of socializing,” he said.  

Other dimensions include occupational wellness where employees are recognized for achievements; environmental wellness creating a stimulating environment for workers; financial wellness offering security and education around finances; intellectual wellness allowing people to continue to learn and grow; emotional wellness that allows people to have hope even when their brain tells them there isn’t; and spiritual wellness, whether religious or holistic. 

“It doesn’t cost companies a lot to address these,” he said, adding it is important to find out what employees need by asking, not assuming. 

“You need to continue to evolve in this area to help everyone be successful,” he said. He used a tree as an example. When it comes to wellness, “there isn’t just one branch. 

“The eight dimensions of wellness address the different seasons of life,” he said. “If you take care of your employees, you find the key to success.” 

Virtual health care, which came to the forefront during the pandemic, has been around for at least 20 years, according to the panelists speaking on the subject.  

But while it has been in use, reimbursement wasn’t always available.  

Dr. Mark Jacobson, medical director, Pharmacy/Clinical Market Services for Highmark, said Highmark has changed its reimbursement policy to equal in-person visits. 

During COVID, from February 2020 to April 2020, there was a 5,000% increase in tele visits. Specifically, he said, there were 75,000 visits between March and December 2019. Visits increased to 3 million between March and December 2020.  “It was an explosion,” he said.  

In addition, he said some telling data showed that of the visits in 2019, 23% were for behavioral health. That jumped to 54% in 2020.  

The bottom line to virtual visits is the reimbursement. Dr. Jason Marx, president, Medical Group, UPMC in Central Pennsylvania, said there was no compensation to grow programs before COVID. “The hospitals had to pay” to provide the service. 

Now, he said, insurance companies have changed so now the services are covered.  

“We’ve just scratched the surface,” said Faraaz Yousuf, executive vice president and COO, WellSpan. “There is unlimited potential to improve care and lower costs,” he said.  

The key is finding “the sweet spot” between virtual visits and in person consultations, he added.  

This is especially true in behavioral health. “The stigma is gone with telehealth because you no longer have to walk into a building where people know where you are going,” said Marx. “It increases access.” 

Tracey Lavallias, executive director, Behavioral Health Services Line, Penn Medicine, Lancaster General Hospital, said telehealth can help too because there is a lack of providers for people not needing in-patient care.  

“It’s an access issue. Of the patients seen in the emergency department, 60% may not need impatient care but they need to find outpatient coverage and medication management,” he said. “But the waiting list is significant.” 

Jennifer Jordan, vice president, Regulatory Advocacy, HAP, said demand for behavioral health services is displacing other services in hospitals making increased access a top priority.  

“We are working on coordinating care,” said Karie Batzler, director of Behavioral Health, Capital Blue Cross. “During the pandemic it became obvious what’s been needed for years,” she said.  

When looking at behavioral health, which includes substance abuse, the panelists said the medical community needs to look at what preventative care looks like. “We need to think ahead and take advantage of what is front and center,” Batzler said. “We need to get information to providers on how to look for this.” 

They all agreed that the focus should start in the schools teaching how to identify when feelings are an issue and reduce the stigma of talking about it.  

“If we teach and normalize this, when someone experiences it, they can identify it and deal with it. Then as adults they can continue, Lavallias said.  

Jordan noted that Pennsylvania passed a one-time $100 million allocation to mental health in the budget. A meeting later this week will determine how it is used, she said.  

“People aren’t comfortable talking about this,” said Batzler. “We need to take a risk” and ask for help when needed. “Employers can make a big difference here” by encouraging employees to do just that, she added.