The Breakdown: The impact of COVID-19 on primary care

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Published

By Dr. Sanjay Basu, Director of Research and Population Health

“The Breakdown” is a series examining the latest developments in health and wellness, sharing what the research says about some of today’s most pressing issues, what it doesn’t, and where we still have more work to do. At Collective Health, we take a rigorous approach to our research to ensure we’re making informed decisions that improve the health of our members. In “The Breakdown,” we’ll share the insights we’ve learned through that process.

As our healthcare system tries to recover from the disruption caused by COVID-19, primary care practices across the country have been decimated. Make no mistake, this is a crisis within a crisis, as primary care has proven to be one of the most important institutions underpinning our healthcare and public health systems.

A quick primer on the importance of primary care, and its deterioration in recent years:

My colleagues and I from Harvard Medical School published a new paper in Health Affairs, a peer-reviewed journal, exploring the financial ramifications on primary care across the country as a result of COVID-19. The current pandemic has forced virtually all in-person outpatient visits to be cancelled in many parts of the country between February and May 2020.

As shown by the Commonwealth Foundation, only a subset of these visits were successfully replaced by telemedicine visits, many patients deferred necessary visits for chronic illness treatment and labs, and many needs of patients (such as in-person procedures) could not be replaced by telemedicine. We sought to estimate the potential impact of COVID-19 on operating expenses and revenues of primary care practices, to understand how COVID-19 might impact the availability of primary care for our members.

At a glance, here’s what we discovered:

These findings underscore the need for a plan that provides support for independent primary care doctors, including small independent practices, which tend to serve disproportionately rural and underserved populations.

We need a widespread, coordinated effort to prop up the primary care practices that are so critical to our communities. The paper itself proposes some efforts, including moving to capitation payments (such as paying practices per patient rather than per visit, to focus on caring for the population rather than just visiting patients more), and value-based payments (paying for keeping patients healthy, not just doing more labs or procedures). Recently, Blue Cross of North Carolina announced an important initiative to extend capitation payments and value-based payments, a step in the right direction.

Collective Health’s Approach
At Collective Health, we’ve invested in many such initiatives, and will continue to build on them. In the months to come, we’ll have more to share, including some early results. For now, here’s a snapshot of what we’re working on in an effort to support primary care practices across the country:

For more information on Collective Health, please reach out.

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