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A sigh of relief on the frontlines of independent primary care

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Ready for some hopeful signs? We’ve been following the trends for independent primary care practices very closely during COVID-19 and there are some truly bright spots to share this week.

Our community of independent practices includes 14,000 clinicians in both fee-for-service (FFS) and direct primary care (DPC) practices. In early March, there was panic as some practices told us they would be out of business as early as May with appointments canceling at a dramatic rate.

Thankfully CMS listened. And they offered help. Quickly. Arranging up to 3 months of advance payment for Medicare providers in just one week. My dad’s solo primary care practice got its advance last week:

Then on Friday, in a surprise to everyone, HHS directly deposited $34B of even more relief funds into provider bank accounts. Practices found funds in their bank accounts overnight.

And CMS wasn’t the only helper. Grant programs from HealthNet and BlueShieldCA  and other health plans are offering emergency funding to help primary care practices adapt to virtual care:

This week, FCC opened up applications for the $200M COVID-19 telehealth program, which will provide direct funding to health care providers for costs of providing telehealth, like connectivity and devices.

All these relief programs can be a lot for our independent PCP practices to navigate, but this rapid response from healthcare leaders has created hope.

Widespread medical practice staff layoffs have been predicted by Bob Wachter  and Dr. Farzad Mostashari among others. Across our primary care network, there’s been a 12.5% reduction in daily staff user logins. No reduction in physician daily logins.

Shoutout to Tom Valenti who had the same idea as our team to look at logins to see if we could track any layoff or furlough activity in independent primary care practices:

Primary care visits seem to be stabilizing at 20% less than normal volumes. We’re not tracking big changes in message volume either. Primary care practices seem to be settling into a new normal with the switch to virtual care.

Still concerned about the 50% drop in primary care for patients 70+ years old in any format we saw early on. A small increase (4%) here in the last week is hopeful.

This third wave of COVID impact on patients living with chronic illness is something for practices stay ahead of:

Our practices on predominantly capitated (per patient) payments are feeling lucky right now. Many DPC practices that are paid monthly fees by patients directly are also feeling stable, some are considering taking Medicare again to help more people.

Will be interesting to see how independent primary care mindsets towards alternative non-FFS payment arrangements change post-COVID. This pandemic has shown how exposed FFS models leave physicians.

At Elation Health, our team is busy helping independent primary care practices get to a new normal. Still a lot of work to be done on telemed, grants, COVID care coordination, virtual population health for people with chronic illness…it’s a whole new world.

What do you want to know about what’s happening on the frontlines of independent primary care practices? Happy to share data as the world changes.