The study also looked at the differences between independent, community oncology and hospital or institutional care settings. The analysis observed an average difference of 10 percentage points in billing frequencies between the settings for cancer-related services from March-July 2020. This is likely a reflection of the dramatic impact of COVID-19 on hospital resources to treat COVID-19 patients, in addition to the ability of community oncology practices to keep their doors open while complying with CDC guidelines and state reopening requirements. Furthermore, community oncology practices have been able to invest resources needed to rapidly adopt telehealth services, providing a critically important treatment option for patients in need.
Lucio Gordan, MD, study co-author, president and managing physician of Florida Cancer Specialists & Research Institute, and member of the COA Board of Directors, applauded community oncology for adapting and taking on new patients and maintaining open clinics for established patients on treatment during the pandemic.
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"Community oncologists and their team members showed incredible resilience and resolve to deal with this severe crisis, by adopting telehealth very quickly, reorganizing workflows, enhancing safety processes at their clinics, and migrating staff to work from home, among other strategies. Although a decrease in services was inevitable, I think the resilience of these practitioners absorbed what could have been a much worse situation," he said.
A shining light during the period was the adoption of telehealth. While many providers quickly pivoted to virtual telehealth visits, its use was only able to slightly lower the reduction in E&M utilization (-73% without telehealth services vs. -58% with telehealth services in April 2020). Further highlighting the different experiences of care settings during the pandemic's summer months, utilization of telehealth has been almost entirely driven by providers in non-hospital settings of care, such as independent physician offices, who provided approximately 95% of telehealth E&M services in April through July.
COA and Avalere Health also report reductions in cancer biopsies in April 2020 and July 2020 compared with those months in 2019 for breast (-71% to -31%), colon (-79% to -33%), and lung (-58% to -47%), respectively. The study also finds a marked decrease in cancer-related surgeries in April and July 2020 compared with those months in 2019, including mastectomies (-56% to -44%), colectomies (-61% to -37%), and prostatectomies (-56% to -43%), respectively.