COVID19 And The Health Care Industry

Patient visitation declines during a pandemic are expected to cost primary care practices in the United States $15 billion in revenue.

Primary care practices are expected to lose more than $65,000 in revenue per full-time physician in 2020, following dramatic drops in-office visits and fees for services from March to May during the COVID-19 pandemic, according to a study led by researchers at Harvard Medical School's Blavatnik Institute.

According to the analysis, the lost revenue amounts to a $15 billion shortfall for primary care practices across the United States. Additionally, the researchers warn that losses would increase significantly if a second viral peak occurs later in the year or if reimbursement rates for telehealth visits return to pre-COVID levels.

Sanjay Basu, director of research and population health at Collective Health and a faculty affiliate at HMS's Center for Primary Care, Russell Phillips, center director and professor of global health and social medicine at HMS, and Bruce Landon, HMS professor of health care policy, led the study.

"These losses could be catastrophic for many primary care practices, particularly those serving the most vulnerable populations," Basu said. "This could significantly weaken the United States' health system at a time when we need it to be at its strongest."

"Our prior research demonstrates that primary care saves lives, and the loss of primary care practices will result in the loss of lives throughout the United States," Phillips said.

To determine the projected financial losses on operating expenses and revenues, the researchers simulated the pandemic's impact on a variety of practices, analyzing both visit volume and visit type, among other variables. They then compared anticipated revenues, expenses, and losses under a variety of scenarios, including a second shelter-in-place order in November and December and reverting to pre-pandemic levels of provider reimbursement for telemedicine visits.

Once the acute threat of COVID-19 has passed and the pandemic has subsided, primary care in the United States will bear the brunt of long-term COVID-19 care and management, testing, and vaccination, the team said. Additionally, they said, the primary care system must be equipped to address the population's accumulated needs and refocus its efforts on the major chronic medical conditions that will collectively determine the health of Americans for many years to come.

"The coronavirus pandemic demonstrates the primary care system's fragility," Landon explained, noting that "more than half of primary care practices remain small and physician-owned, and these independent practices lack access to capital and other support that could help them weather the pandemic."

The researchers stated that their findings, combined with the impending growth in primary care use, highlight the critical need for financial support for the primary care system.

"The coronavirus pandemic serves as a stark reminder of the critical role primary care plays in our society. Primary care is critical for containing the virus's spread, treating the comorbidities that can make COVID-19 so lethal, and assisting people in navigating the social and psychological difficulties associated with social isolation and living with the pandemic "According to Phillips.

While legislation providing financial assistance to hospitals has been introduced in Congress, the researchers noted that independent primary care practices have yet to receive significant financial assistance.

Additionally, colleagues from the American Board of Family Medicine collaborated on the study.

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