April 20, 2022 | Article
The COVID-19 pandemic has accelerated trends in the healthcare industry. A survey of Latin American physicians reveals how they believe the industry will evolve as the pandemic evolves and the future unfolds.
Healthcare systems in Latin America have played a critical role in protecting human lives during the COVID-19 pandemic. They are also among those industries most affected by the crisis due to unanticipated costs, the suspension of nonurgent healthcare services, emotional exhaustion of the healthcare workforce, and the untimely deaths of many healthcare workers who lost their lives in the line of duty.
Moreover, the healthcare sector will experience a tremendous amount of long-term, disruptive change—sparked or accelerated by the pandemic—in the months and years ahead. Frontline healthcare providers can offer a unique perspective on the changes occurring in the industry and how the future of healthcare is likely to unfold.
McKinsey surveyed physicians across Latin America to understand their perceptions of how the COVID-19 crisis is reshaping healthcare systems in the region (see sidebar, “Our methodology”).
Physicians expect healthcare volumes to rebound in 2022, and supporting telehealth is their preferred strategy for improving patient access
To help our clientsunderstand responses to COVID-19, McKinsey surveyed 517 general and specialty physicians across five countries in Latin America from October 14 to November 17, 2021, to gather insights on how the pandemic is shaping healthcare delivery in the region. The survey tested perspectives on five main topics: financial health, return of elective care, site of care delivery, telemedicine, and value-based care.
Participants included 517 physicians from Brazil (122 physicians), Chile (90 physicians), Colombia (94 physicians), Mexico (121 physicians), and Peru (90 physicians). Physician specialties included anesthesiology, cardiology, emergency medicine, general practice, general surgery, geriatrics, immunology, nephrology, obstetrics and gynecology, oncology, ophthalmology, orthopedics, otorhinolaryngology, and pediatrics.
COVID-19 caused the volume of medical services delivered to drop dramatically during 2020 and 2021: 80 percent of surveyed physicians reported a reduced number of patients since the onset of the pandemic in all countries surveyed. On the other hand, physicians surveyed predict an approximately 25 percent increase in outpatient medical consultations, hospitalizations, and surgery volumes in 2022. Across the five countries surveyed, the most popular strategy for helping patients return to care is offering virtual options such as telehealth (Exhibit 1).
Telehealth is now a core offering that physicians expect to continue even after in-person visits return
The survey found that 60 to 84 percent of physicians were actively offering telehealth services. Among these physicians, 20 percent on average introduced telehealth during the pandemic, and 80 percent reported they plan to continue doing so in the future as part of a hybrid care model for at least a few hours a day or for one day a week (Exhibit 2).
In addition, more than half of all physicians surveyed consider telehealth to be less costly for their practice than in-person visits, and two-thirds view telehealth visits as effective, especially for follow-up visits and nonurgent primary-care consultations.
Physicians expect more care to shift out of hospitals, primarily into patients’ homes
The shift from hospitals to other locations, including patient homes, for in-person care has also accelerated since the start of the COVID-19 pandemic. Survey respondents expect that by 2025, care will take place in patients’ homes an average of 1.5 times to 2.5 times more often than it does today (Exhibit 3). They expect an average of 35 percent of all palliative-care, mental-health, primary-care, and physical-therapy services to be delivered in the home by 2025. For three services—intensive care, emergency care, and dialysis—they expect home care to more than double its current state but achieve a lower absolute percentage of services in the home.
Physicians surveyed for the most part do not consider pharmacies to be a preferred location for most care services—although, in Mexico, 14 percent view them as appropriate for vaccine administration, and 7 percent consider them appropriate for physical therapy.
The pandemic has reaffirmed physicians’ commitment to their clinical careers, although their preferred practice model is shifting in some countries
Despite personal health risks associated with providing care to patients during the pandemic, the physicians surveyed in all countries are still committed to their careers; in fact, 90 percent say they are now less likely to leave medicine than they were before the pandemic. However, their interest in switching from independent practice to working for a healthcare system has increased (Exhibit 4).
Physicians anticipate a shift to value-based care in the future
Nearly half of the physicians surveyed believe value-based care improves the quality of patient care. Meanwhile, an average of 55 percent think their revenues will increase, and an average of 20 percent believe it will have no effect on their revenues (Exhibit 5). However, more than one-third of physicians surveyed overall and more than half in Mexico and Peru also believe fee-for-service models improve quality of care. Physicians reported they are now more willing to use outcome-based payer contract agreements and believe that in two to three years, 15 percent more patients will be treated under these models than are today.
COVID-19 trends will affect healthcare stakeholders across the value chain, including payers, providers, patients, pharmacies, and investors
COVID-19 has accelerated change in the healthcare industry and catalyzed new trends across Latin America. Telehealth and the shift to at-home care have met or exceeded patient expectations, and they may unlock lower healthcare costs in the future, although potentially at the expense of traditional hospital revenue streams. Stakeholders across the healthcare value chain likely need to accelerate their digital transformations to reflect new care models while boosting efforts to enhance the patient experience and incorporating new care sites into their operations.
Digital health ecosystems: Voices of key healthcare leaders
More physicians now see the benefit of shifting from fee-for-service to value-based care to improve quality of care and their future financial stability. Healthcare ecosystem participants will need to develop the necessary capabilities to implement true value-based care models that benefit all stakeholders of the system. Furthermore, those most likely to succeed in this shifting environment will adopt hybrid ecosystems that embrace telehealth and at-home care when clinically appropriate, adding value to the healthcare system while providing patients with affordable care.
ABOUT THE AUTHOR(S)
Felipe Child is a partner in McKinsey’s Bogotá office; Roberto García is an associate partner in the Mexico City office, where Jorge Torres is a consultant; Laura Medford-Davis, MD, is an associate partner in the Houston office; and Robin Roark, MD, is a partner in the Miami office.
The authors wish to thank Andrés Arboleda, Sebastian Gonzalez, Pollyana Lima, Romina Mendoza, Claudia Mones, Tiago Sanfelice, and Javier Valenzuela for their contributions to this article.