ACP monitoring spending of allocated funds, advocating for physician support and working to ensure guidelines to resume activities are reasonable
May 1, 2020 (ACP) – As the nation's leaders gear up for more rounds of debate about how to support the country during the COVID-19 pandemic, the American College of Physicians is advocating for solutions that protect public health while restoring the economy as much as possible.
“Our work isn't done, not by a long shot,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “We've provided recommendations every step of the way about how to put patients first and keep our health system strong. We have much more to do as Congress begins to figure out what comes next.”
Here's a look at the top priorities for ACP advocacy in the weeks ahead.
Monitoring the spending of allocated funds. In late April, the president signed a $484 billion coronavirus relief bill to provide new money for struggling hospitals, clinicians and small businesses. ACP is closely watching the rollout of $320 billion in extra funding for the Paycheck Protection Program, which is providing forgivable loans to small businesses that will pay for up to two months of payroll costs from the last year plus an additional 25 percent.
“We've been very supportive of these loans because they're a way for small businesses to not have to lay off staff,” Doherty said. “A lot of physicians were turned away during the first round of funding because the money ran out. Hopefully, physicians will be able to get approval quickly. Many practices are within days or weeks of having to lay off staff.”
Advocating for new support for physicians. The stimulus bill also includes $75 billion in funding for hospitals and practices to make up for lack of revenue due to the pandemic. ACP praised the funding in a letter to congressional leaders but cautioned that the money must be “prioritized to support physicians and their practices with the greatest need, and who are especially critical to patient care during the COVID-19 public health emergency.”
ACP called on prioritizing primary care physician practices, smaller practices with 15 or fewer clinicians, internal medicine subspecialists who care for patients with complex chronic diseases and physicians in underserved rural and urban communities.
“The coronavirus death toll tends to be much higher in certain underserved populations like African-Americans,” Doherty said, “and we want to support physicians who provide care to those underserved populations.”
On another front, ACP is proposing monthly per-patient payments to primary care practices in particular, adjusted by patient demographics, to help sustain them through the COVID-19 pandemic.
Supporting reasonable guidelines to resume economic activity. ACP has identified five criteria that must be met for regions of the nation to “reopen” after largely shutting down to prevent the spread of the coronavirus:
- Screening and testing: Widespread administration of a reliable method of testing for COVID-19 and accurate/reliable emerging antibody testing must be established to accurately determine that a downward trajectory is being evidenced and sustained. Consent and sufficient privacy protections for patients being tested must be in place.
- Prevention measures: An approach to scale up tracing of the contacts of those who test positive (contact tracing) must balance public health needs with confidentiality and privacy protections for patients. “Most Americans would understand that if they have the virus, even if they have no symptoms, it's appropriate for public health agencies to ask who they've seen,” Doherty said. “However, there's legitimate concern about misusing the information gathered.”
- Infrastructure: Sufficient workforce and supply capacity must be available for testing, analysis and follow-up.
- Resources: Personal protective equipment must be available for every frontline physician, nurse or other professional health care worker.
- Infrastructure: There needs to be sufficient hospital, physician and health system capacity to treat patients with the virus.
Monitoring immigration restrictions. “We were concerned that the president's new executive order to shut down all immigration might make it impossible for international medical graduates to come here for residency programs and cut off the ability of other scientists to be able to come to the United States,” Doherty said. “We issued a statement expressing concern, and we are encouraged that the final order exempted international medical graduates from the new restrictions”
What's next? Earlier this week ACP sent a letter to the Department of Health and Human Services with recommendations for prioritizing relief funding for physicians and their practices. Additionally, ACP is developing more recommendations in areas such as testing, privacy and procedures to allow physicians to begin routinely seeing patients again. “We're also going to be developing our priorities for the fourth stimulus package,” Doherty said. “We will make sure policymakers understand where our hundreds of thousands of members stand.”
Additional resources to help physicians and their practices deal with COVID-19 are available on the Practice Resources section of the ACP website.