5 Variables Affecting Imaging Volume Recovery During COVID-19

Diagnostic imaging is central to healthcare delivery and a significant contributor to hospital revenue. Amidst the global pandemic, radiology has experienced a substantial decrease in volume as patients were deterred from seeking non-emergency imaging services resulting in revenue losses.

Despite rising case numbers nationwide, radiology is steadily returning to normal imaging volumes as elective procedures return. Estimating and preparing for the resumption of radiology volumes will be a major challenge for hospitals and health systems. To help healthcare leaders plan and prepare for healthcare’s “new normal”, a study in the American Journal of Radiology identified 5 variables that will influence the rate and degree to which imaging volumes will recover in the weeks and months ahead.

Severity of Disease in the Local Region

The intensity of the COVID-19 pandemic in a specific area will be the primary driver of volume recovery. Less affected regions will have a more rapid recovery period, while highly impacted areas will experience longer recovery times. Public health officials anticipate a second wave of infection. The impact on volumes will likely be less prominent however as healthcare institutions have had more time to implement COVID-19 protocols.

Lifting of Social Distancing Restrictions

Currently, most states have some sort of social distancing mandate in place. Government leaders are starting to lift those restrictions; however, it varies from state to state. A prompt lifting of restrictions will lead to a rapid return of imaging volumes, while a delayed lifting will prolong the return to normal volumes.

Patient Concern

The perception of risk associated with entering healthcare facilities to undergo imaging procedures will likely influence the rate of restoration of radiology volumes. Although stay-at-home restrictions are lifted, patients may still delay care out of fear of contracting the virus. Achieving pre-pandemic levels of patient confidence will take time. Healthcare facilities will need to work hard to assure patients that they are taking the necessary precautions to ensure their safety.

Management of Pent-Up Demand for Imaging

The postponement of elective imaging exams has led to a backlog of unordered and ordered-but-not-yet-performed procedures. The size of the backlog depends on the severity of the pandemic in the region. Areas that were minimally impacted will be able to quickly schedule delayed exams, leading to an initial bump in imaging volumes, possibly even above normal operating capacity. Widely impacted areas would experience much the opposite. Delayed exams would take time to schedule and perform, delaying the return to normal imaging volumes. Factors leading to this may include being understaffed due to layoffs, implementing enhanced cleaning protocols and equipment shortages.

Impact of Economic Downturn

The COVID-19 outbreak and the economic downturn it prompted increased the national unemployment rate to 11.1%.4 The economic decline will likely affect radiology volumes due to the loss of employer provided insurance coverage and the inability to pay deductibles or copays. Regions with a large population that have lost full healthcare coverage can expect to see a slower return to pre-pandemic imaging volumes than areas whose population has retained employment. CMS issued guidelines for Medicare Advantage Organizations, giving them the discretion to waive or relax prior authorization requirements to improve access.5 Physician organizations including the American College of Radiology have urged private insurers to implement similar policies. These steps may improve the rate of recovery to baseline volumes.

Recovering imaging volume is crucial to driving hospital revenue especially in the aftermath of the pandemic. Gaining an understanding of likely imaging volumes post-COVID will ensure that hospitals and healthcare systems are best prepared to provide safe effective patient care in the months ahead.

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