Medical professionals are warning healthy individuals to stay home and out of emergency rooms if they can. But an unexpected effect of that advice has also crippled private practice physicians’ offices. Texans aren’t going to see their primary care physicians.
The Texas Academy of Family Physicians published research that shows primary care physicians have seen a drop in patient visits of more than 50%. A family physician office group in Frisco and North Dallas has furloughed 70 employees and cut physician pay by 20%. And they’re not alone.
Many primary care and specialty physicians are suffering financially because of the stay-home orders, as patients cancel elective or nonurgent surgeries and stop coming in for routine care.
When doctor’s offices and hospitals open back up for nonurgent procedures and surgeries, will there be an overwhelming demand for services but a devastating lack of income for these offices to be able to stay open?
The Texas Academy of Family Physicians says there is a solution. It’s called the Marshall Plan. First introduced in the aftermath of World War II, it proposes an economic assistance and restorative plan for infrastructure, especially in the health care system.
One of the most important reasons a differently structured assistance program like the Marshall Plan is necessary is because the coronavirus crisis is a result of system design failure, TAFP said.
“For years, health care experts have been warning of the dire consequences of persistently underfunding primary care and public health at the federal, state and local levels,” TAFP CEO Tom Banning said in a blog post, published along with Christopher Crow, MD, MBA, President of Catalyst Health network. “COVID-19 has vividly exposed gaping cracks in our siloed, fractured and disconnected health care system.”
TAFP says the first way a new Marshall Plan would help is by shifting the way primary care is paid for, from a transactional fee-for-service method to a prospective payment design.
“This means health insurance companies, Medicare, Medicaid, and all other payers would pay primary care providers a fixed monthly fee for a broad range of services rather than paying a claim for each service,” Banning said. “To determine the amount of the monthly fee, payers could examine what they paid for primary care in the last year and then pay their primary care providers at a commensurate monthly rate for the coming year. Or it could be based on a percent of the premium cost.”
Banning also noted that this isn’t a new idea. TAFP believes this system would allow patients regular access to care with a predictable and manageable cost, while also providing dependable income for primary care practices.
“It’s not a crazy idea,” Banning said. “This is exactly how we pay providers in Medicare Advantage today and the Centers for Medicare & Medicaid Services has been testing this through other pilot projects.”
Other key features of the plan include encouraging and accelerating the use of telemedicine, promoting greater use of primary care by improving the kind of care PCPs can provide, and stockpiling personal protective equipment and other necessary supplies for better preparedness for future pandemics.
Banning also emphasized that health care workers are a vital part of this plan. TAFP believes that enabling workers to more easily access education at lower costs or through loan forgiveness or better funding would help generate a stronger workforce of physicians who can work in a better-designed health care system that truly serves patients.
“The Marshall Plan was initiated three years after the end of World War II. With the current crisis threatening our frontline primary care physicians, we don’t have the luxury of waiting that long,” Banning said. “We must save our frontline primary care and public health professionals and in so doing, set the foundation for a better way of delivering and paying for care. If we ignore the primary care workforce crisis unfolding before us, the long-term consequences to our health care system will be dire.”