Manifest MedEx: Millions of Californians Fell Behind on Medical Care During Crisis

Manifest MedEx, California’s largest nonprofit health data network, has released a report indicating that Californians fell as much as 50 percent behind on medical care—particularly preventive screenings and children’s health—during the pandemic.

The report is an analysis of the impact of COVID-19 on healthcare utilization in California, and aims to equip healthcare providers and leaders with important insights to address gaps in care and plan for future public health events. The findings are based on an analysis of a longitudinal cohort of just over 4 million Californians, or about 10 percent of the state’s population. Also included in the report are recommendations on how health policy officials, clinicians, and health plans can come together to address the gaps in care.

The California HIE says it facilitates information sharing across more than 500 healthcare organizations, including over 90 California hospitals and seven health plans.

According to the CDC, at least 41 percent of U.S. adults have delayed or avoided necessary medical care to prevent infection from COVID-19. Without proactive interventions, many patients who deferred care will deteriorate to more advanced disease states, end up admitted to the hospital, or develop new diseases that go undetected in their early stages, demanding more costly care in the future. All told, deferred care could increase annual U.S. healthcare costs by $30 to $65 billion, according to a McKinsey analysis from last fall.

As such, key findings of the Manifest MedEx report, comparing healthcare utilization during COVID-19 to pre-pandemic levels, include:

• Ambulatory visit volumes across the state initially fell by more than 50 percent. Although visit volumes quickly rebounded, they remained about 20 percent below baseline levels.

• Ambulatory visit declines for children and adolescents were substantially larger than for adults.

• The volume of preventive services, such as cancer screenings, fell between 20 and 40 percent. This included drops for mammography (-20 percent), colonoscopy (-34 percent) and cervical cancer screenings (-41 percent). It will thus be extra important to catch up quickly on these screening services and monitor whether cancers are diagnosed at later stages across the next few years.

• In contrast, volumes for other services, such as hip arthroplasty and PET scans, were down only modestly for the year.

“As California reopens, this report shows that the entire healthcare system needs to prepare for a major surge of catch-up care,” said Claudia Williams, CEO of Manifest MedEx. “Let’s be smart about how our state handles these aftershocks. This is a key moment for the population health management infrastructure Manifest MedEx has been building for years which gives providers and plans the insights they need to reach patients most in need, ensuring they get essential health and preventive services.”