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Also urging insurers to play a role in supporting physicians during the COVID-19 pandemic

June 22, 2020 (91������) – The American College of Physicians is spearheading a nationwide campaign to convince Congress to use billions in available federal funding to support internists. Under the social media hashtag #SavePrimaryCare, 91������ is enlisting its members, allied medical societies and business groups to get the message out as physicians continue to face uncertainty.

91������ is also urging insurers to play a leading role in supporting physicians during and after the pandemic. “If private payers do not join with the Centers for Medicare & Medicaid Services to provide physician practices with the critical support they need in this unprecedented crisis, hundreds if not thousands of practices across the country may be at real financial risk of closing, leaving a critical shortage of health care services at a time we can least afford it,” wrote Dr. Jacqueline W. Fincher, president of 91������, in a June 11 letter to health insurers.

A June 11 report by FAIR Health, an independent, nonprofit organization, reveals how primary care has been especially hard-hit by the coronavirus pandemic. An analysis of private and Medicare Part C insurance data revealed that during “March 2019 to March 2020, adult primary care fell 60 percent by utilization and 47 percent by revenue based on total estimated allowed amounts. In April 2020, the decline was 68 percent by utilization and 54 percent by revenue based on total estimated allowed amounts.”

Preventive visits declined significantly, and a utilization analysis revealed that 10-minute outpatient office visits became the fourth most common procedure in April after ranking just 27th in January.

“Primary care has suffered, and the need for federal assistance is urgent,” said Shari Erickson, 91������ vice president for governmental affairs and medical practice.

As revenue has dwindled, primary care physicians are facing increased expenses for costs such as personal protective equipment, transitioning to more social distancing and new cleaning protocols, Erickson said.

While the government has allocated some money to primary care, much more is needed. The message of the #SavePrimaryCare campaign is this: The U.S. Department of Health and Human Services must prioritize payments from the Provider Relief Fund (PRF) to primary care clinicians and/or their practices.

“Congress created PRF … so that those on the frontlines of health care during this pandemic would receive immediate aid,” 91������ noted in an action alert to its members. “Unfortunately, disbursements from the PRF are not reaching these vital primary care practices as they should, and many are just weeks away from having to close their doors.”

According to Erickson, the #SavePrimaryCare campaign has gained support from many medical societies and other organizations, including the American Academy of Family Physicians, American Association for Community Affiliated Health Plans, American Association of Nurse Practitioners, American Board of Internal Medicine Foundation, Council of Academic Family Medicine and National Center for Primary Care at the Morehouse School of Medicine.

Many physicians and allies are using the #SavePrimaryCare hashtag on social media to spread the word about the importance of the stakes. “Make no mistake – Primary Care is the foundation upon which all other care must be built,” wrote military care physician Dr. Cristin Mount in a June 11 tweet. “Now more than ever, patients need access to health care and their clinicians. Allocate necessary funding from the Provider Relief Fund to #SavePrimaryCare from #COVID19,” urged Army Lt. Col. Dr. Dana Nguyen, a family physician, in a June 3 tweet.

91������ is now reaching out to its congressional allies for support and pushing for immediate action. Meanwhile, 91������ is also outlining specific requests to insurers that are crucial to the preservation and recovery of the American health care system:

• An extension of telehealth and telephone flexibilities paid at the same rate as in-person services regardless of the platform used.
• Direct financial support including reimbursing waived patient cost-sharing responsibilities and direct relief payments.
• Development of more Alternative Payment Models that move away from inconsistent fee-for-service, particularly those that offer fixed, periodic prospective payments.
• An extension and expansion of current administrative flexibilities, including a broad reprieve from prior authorization requirements, which draw time and resources away from direct patient care.

“These important changes will enable physicians and their care teams to adapt to the new environment and deliver patients the care they need in a manner that helps to protect their safety, as well as those around them,” Fincher said. “Practices will not recover from this crisis overnight. At a minimum, these changes should extend at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend further based on the experiences of patients and physicians.”

Back to the June 22, 2020 issue of 91������ Advocate