A recent article by RevCycleIntelligence suggests that primary care practices are starting to recover from the pandemic. However, a number of these practices saw major decreases in patient volume that impacted their revenues and required staff and cost reductions.
A survey by the Primary Care Collaborative and the Larry A. Green Center fielded responses from over 650 clinicians working in primary care practices across the country, with most specializing in family medicine and internal medicine and over a fifth practicing in rural settings.
Just 7 percent of the clinicians reported that their practice is unable to pay bills on time, a marked difference from a year ago when the survey series revealed that about a fifth of practices were expecting to close within a month because of financial hardship.
Fewer than 5 percent of clinicians also said loans taken out during the COVID-19 pandemic are coming due and they do not know how to pay them.
Primary care practices are also increasingly joining the nation’s COVID-19 vaccine rollout, with 38 percent of clinicians reporting that their practice is administering vaccines. This is a significant increase from previous weeks when primary care was hardly being leveraged in the rollout effort, researchers stated.
Patient volumes are also rebounding after widespread community shutdowns throughout 2020 to stymy the spread of the virus. Now, over a year later, primary care practices are conducting chronic-care follow-up (91 percent), screening patients for depression or anxiety (92 percent), and performing routine cancer screenings (79 percent).
Additionally, many practices are establishing new partnerships with entities such as community organizations (28 percent), behavioral health services (27 percent) and local pharmacies (19 percent) to bolster services.
But the picture is not all rosy for primary care practices. Just under 40 percent of clinicians feel the level of strain stemming from COVID-19 is the same as a year ago, with a little under half of these respondents saying the strain feels worse this time around. Additionally, about 30 percent of clinicians said their practice received “adequate financial support from the government” during the pandemic.
Common flexibilities enacted during the pandemic included increasing telehealth coverage and reimbursement and waiving all deductibles, copayments, and other costs for insured patients who fell ill with COVID-19. But payers have started to let up some of these flexibilities over a year later.
Primary care practices took a $15 billion hit during the early days of the pandemic, according to researchers from Harvard Medical School and the American Board of Family Medicine. Practices were slated to lose over $65,000 in revenue per full-time physician after drastic declines in both office visits and payments from March through May 2020, they projected.
The researchers said their findings “ultimately highlight vulnerability of primary care practices to financial demise due to fee-for-service and visit-based payment policies, indicating that capitation-based payment reforms may be key to ensuring robustness of primary care into the future.”
The data also shows that practices that fared relatively better during the pandemic had more than 50 percent of their income for primary care based on prospective capitation. Practices with this type of reimbursement structure are under less financial strain than their fee-for-service peers.
Adoption of these type of payment models is still very low, with just 5.1 percent of healthcare payments
made in 2019 coming from this “population-based” payment method, the Health Care Payment Learning & Action Network reports.
Primary care practices were under financial strain prior to the COVID-19 virus. We believe that COVID-19 will push even more primary care practices to merge with health systems or other physician organizations.