The economic impact of COVID-19 on primary care continues to reveal itself through reductions in patient volume, revenue, and increased practice expenses. As the pandemic continues to move into 2021, physician practices continue to be more vulnerable than others within the healthcare spectrum. According to an American Hospital Association survey, primary care physicians are now faced with a 32-percent decline in outpatient care. New safety precautions are also taking a toll on the purse strings of primary care practices. Nearly two-thirds of practice owners reported that they spent 57 percent more on PPE in 2020, than they had prior to the pandemic. Physicians acknowledged that acquiring PPE was also very or extremely difficult.

During the pandemic, federal financial relief such as the CARES Act, Medicare Accelerated and Advance Payment Program and the SBA Paycheck Program was helpful and appreciated by primary care providers – but the relief funding did not solve the underlying revenue issues. As the pandemic continues, providers are still faced with decreased revenue, physician burnout, reduction in staff and increased cost. The road to financial recovery will be difficult and long, especially for small, rural primary care providers.

Many primary care providers are considering closing, consolidating with larger hospital systems or operating for private equity firms in an effort to save money. But this could also potentially drive-up health care costs for the patient, and reduce or delay access to care for patients with cancer or underlying health conditions like prediabetes, diabetes and heart disease. The lack of primary care within a community is strongly connected to reduced preventable mortality and lower costs of care, yet recent surveys suggest that many primary care facilities will soon close without additional support.

How can we support and increase the financial stability of primary care providers after COVID-19? With a full understanding of the “new normal” for primary care providers, we recommend these eight strategies to increase financial stability:

  1. Understand your costs: Organizations must understand and manage current daily costs and make strategic decisions.
  2. Optimize current space: Understand your physical assets and whether they meet the preferences of your patients. Look for ways to increase efficient use of space in ways that are also attuned to your patient population.
  3. Increase productivity within your practice: Determine how to improve patient workflow and cycle times within your practice.
  4. Invest in and understand telehealth/telemedicine: Build a strategy for delivering virtual and telephonic care. Measure how it impacts your overall footprint.
  5. Build a new primary care business model: Start developing a direct primary care model that enhances patient care for local employers, and better optimize virtual care.
  6. Become active in statewide community-led programs: Explore the programs available and led by your state agencies.
  7. Investigate new payment models: Develop relationships with the major insurance companies within your state. Ask about new incentive models that may offer.
  8. Identify and manage your patient population: Use electronic health records (EHRs) to analyze your patient populations. EHRs can improve the ability to diagnose diseases and reduce — even prevent — medical errors, improving patient outcomes.

The Center for Practice Transformation at the SC Office of Rural Health is here to assist you as you look for ways to work more economically and efficiently during the COVID-19 recovery phase. We can help you identify opportunities to provide better care and maximize reimbursement. These solutions include quality improvement methods; new care models; and technical assistance in operations, clinic management or clinical services.

Contact us to start planning for a successful financial recovery from this public health emergency.

by LaShandal Pettway-Brown
Practice Transformation Consultant