Study: Lower Patient Spending Has Primary Care Providers Worried About Future of Practices

Key Insights

• A significant number of patients are delaying care and appointments as a result of COVID-19.
• Decreased revenue has led to higher rates of financial uncertainty and burnout among providers.
• In response, some physician groups have requested insurers make prospective payments to help independent primary care providers remain viable.

The Effect of COVID-19 on Patient Spending

Nearly one-third of Americans plan to reduce or adjust their spending on healthcare visits in response to the coronavirus, according to a survey from PricewaterhouseCoopers. This trend is especially significant among patients with chronic conditions. Within this demographic, 32 percent have considered skipping “routine visits” and 29 percent have considered “skipping recommended laboratory tests or screenings.”

Similarly, a study from the Alliance of Community Health Plans shows that 41 percent of patients have delayed healthcare and 38 percent intend to “delay future care, treatment, and procedures.”

Study: Providers’ Financial Strain and Burnout at “All-Time” Highs

Providers are feeling the effects of these reductions in spending. The resulting decrease in patient volumes is exacerbated by increased expenses for personal protective equipment (PPE), additional cleaning, and more. Recent data shows that 51 percent of primary care providers “are uncertain about their financial future one month out.” More than half of surveyed “clinicians report no payments received in the last 4 weeks for virtual health care,” 18 percent report billing denied, and among those paid, more than 60 percent “report that their telehealth visits are not at parity with face-to-face encounters.” Sixty percent of practices find that “less than half of their work [was] reimbursed.”

Overall, two-thirds of respondents feel “financial stress is at an all-time high” while one-third note “burnout is at an all-time high.” Furthermore, 84 percent of surveyed providers “are experiencing severe or close to severe stress and have continuously for over two months.”

“We are going to close. I doubt I have interest in coming back as it is evident how little we are valued in this system,” said one provider.

Physician Groups Request Prospective Payments to Offset Losses

Some business, consumer, and physician groups are advocating for prospective payments to help independent primary care providers. “The Pacific Business Group on Health and the California Medical Association are asking California state legislators to shore up vulnerable primary-care practices during the COVID-19 crisis,” Modern Healthcare reports.

The groups have asked lawmakers for $2.5 billion in prospective payments to independent primary care providers.

“The majority of primary care practices have low reserves or no reserves — they often exist on a month-to-month basis and don’t have that prospective form of predictable population-based payment — that really puts them at risk of not being able to make it through this tumultuousness,” Asaf Bitton, MD, Executive Director of Ariadne Labs, said in a webinar.

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