Projected $ 15 Billion Loss of Revenue for US Primary Care Due to COVID-19 Closings

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Primary care practices are projected to lose more than $ 65,000 in full-time physician earnings in 2020, following a drastic decrease in office visits and service fees from March to May during the COVID-19 pandemic, according to a study led by researchers at the Blavatnik Institute at Harvard Medical School.

Loss of income adds to a $ 15 billion deficit for primary care practices in the United States, according to the analysis to be published June 25 in Health issues. (DOI: 10.1377 / hlthaff.2020.00794). The researchers also warn that losses would skyrocket if there is a second viral spike later in the year or if reimbursement rates for telehealth visits return to pre-COVID levels.

The study was led by Sanjay Basu, director of research and population health at Collective Health and a faculty member at the HMS Primary Care Center, Russell Phillips, director of the center and professor of global health and social medicine at HMS, and Bruce Landon, HMS professor of health policy.

“For many primary care practices, particularly those that serve the most vulnerable populations, these losses can be catastrophic, and many practices are forced to close,” Basu said. “This could dramatically weaken the US health system. At a time when we need it to be at its strongest point.”

“Our previous work shows that primary care saves lives, and the loss of primary care practices will translate into lost lives in the United States,” said Phillips.

To calculate projected financial losses in operating expenses and income, the researchers simulated the impact of the pandemic on a variety of practices, analyzing both the volume of visits and the type of visit, among other variables. They then compared anticipated income, expenses, and losses in various scenarios, including a second shelter-in-place request in November and December, and also returned to significantly lower pre-pandemic levels of reimbursement to providers for telemedicine visits.

Once the most serious threat from COVID-19 subsides and the pandemic subsides, primary care in the United States will have to absorb the brunt of COVID-19 care and management, testing, and vaccination in the long term, said the team. The primary care system must also be equipped to meet the cumulative needs of the population and turn its attention to the major chronic medical conditions that will collectively determine the health of Americans for many years, they said.

“The coronavirus pandemic highlights the fragility of the primary care system,” said Landon, noting that “more than half of primary care practices remain small and physician-owned, and these independent practices have limited access to capital and other support that could help them weather the weather. ” pandemic.”

The researchers said their findings and the impending growth in the use of primary care underscore the need for a financial boost to the primary care system.

“The coronavirus pandemic is a timely reminder of the importance of primary care for our society. Primary care is critical in limiting the spread of the virus, in treating comorbidities that can make COVID-19 so deadly, and in helping people navigate the social and psychological challenges of social alienation and living with the pandemic. “Phillips said.

While legislation proposing financial aid to hospitals has already been introduced in Congress, independent primary care practices have yet to receive significant financial aid, the researchers said.


Reference: June 25, 2020, Health issues.
DOI: 10.1377 / hlthaff.2020.00794

Additional collaborators in the study include colleagues from the American Board of Family Medicine.

The authors report that there are no external funds for this study.