As patient volume remains low amid the COVID-19 pandemic, ACP requests funds be allocated to practices to make up for lost revenue and increased costs
June 5, 2020 (ACP) – The American College of Physicians (ACP) is urging the U.S. Department of Health and Human Services (HHS) and Senate leaders to create more targeted allocations from COVID-19 emergency funds to keep primary care practices open, similar to what has been done for struggling rural hospitals.
The targeted allocation would come from the Provider Relief Fund, which includes $175 billion for hospitals and health care clinicians and physicians on the front lines of the coronavirus response. In a letter to HHS Secretary Alex M. Azar, ACP suggests these funds be tapped to offset 80 percent of the revenue being lost from all payers, including Medicare, Medicaid and private insurers, retroactive to April 1 through the end of the calendar year, after considering disbursements already received by such practices from the general Provider Relief Fund allocations. They also called for the targeted allocation to cover costs incurred to purchase personal protective equipment and other supplies to deal with COVID-19.
ACP begins to address the “how” in the letter to Secretary Azar as well. Funds could be disbursed as a single lump payment, through quarterly payments or through per-patient per-month payments, ACP notes. To receive the targeted allocation disbursements, primary care physicians and their practices could be required to attest to the amount of revenue lost from all payers as well as increased costs by providing appropriate, but not excessive or overly burdensome, documentation.
“Primary care practices are not going to see patient volume return any time soon, and targeted allocation will help practices keep their doors open and see patients now and when we start to move out of the pandemic,” said Shari Erickson, ACP vice president for governmental affairs and medical practice.
This targeted aid is essential, added ACP President Dr. Jacqueline W. Fincher, in a news release. “Many small primary care practices, like mine, are struggling to make ends meet in this unprecedented public health emergency,” she said. “A targeted allocation to practices and specialties — internal medicine, family medicine and pediatrics — that principally provide primary and comprehensive care to patients is needed to ensure they can keep their doors open. Without this they may be forced to close or sell out to equity firms or large consolidated health care systems, driving up health care costs and reducing access to care.”
The HHS has already allocated $10 billion from the Provider Relief Fund for struggling rural hospitals, and primary care practices are being hit just as hard by the pandemic, Erickson noted. “Besides decreasing patient volume, delayed care will lead to complications, which makes it more challenging to treat patients,” she said.
Members can and should do their part to advocate for targeted allocation for primary care, Erickson said. “Echo our message to your state and local representatives and send emails to Secretary Azar,” she said. ACP is encouraging all members to use the hashtag #SavePrimaryCare in social media posts and direct outreach. “Tell your story,” Erickson said.
ACP is urging HHS to make more options available to enable primary care physician practices to transition away from fee-for-service by providing per-patient per-month prospective payments adjusted for patient demographics. Fincher points out that the COVID-19 pandemic has highlighted many of the flaws of traditional fee-for-service reimbursements and now wants HHS to expand programs and give opportunities to practices to move toward new payment models that tie reimbursement to value, not volume.
The Centers for Medicare & Medicaid Services has removed many hurdles for physicians during the pandemic, including those that hindered telehealth and telephone services, and ACP is asking that these continue at least through the end of this year. “We can't just turn off these services and flexibilities,” Erickson said. “We need to have time to learn from them.”
Up-to-date practice management resources during the COVID-19 pandemic are available on the ACP website.