1/ This thread will be alarming, I'm sorry.
The American Academy of Family Practice CEO is crying out about the financial crisis threatening frontline primary care practices, but no one seems to be listening
I'll give you some news from those frontlines (and ask for your help)
The American Academy of Family Practice CEO is crying out about the financial crisis threatening frontline primary care practices, but no one seems to be listening
I'll give you some news from those frontlines (and ask for your help)
2/ We are hearing first hand the front end of a massive wave about to swamp PCPs
A family practice in Arkansas that's been in business for 50 years just laid off 12 staff member.
A practice in NC says they have 2 weeks until they go broke
This is one practice's cancellations
A family practice in Arkansas that's been in business for 50 years just laid off 12 staff member.
A practice in NC says they have 2 weeks until they go broke
This is one practice's cancellations
3/ Those are practices in areas that are NOT yet heavily impacted by the outbreak.
Here is what it looks like at a practice where the virus is spreading
Here is what it looks like at a practice where the virus is spreading
4/ Our practices are TELLING their patients to stay home and stay safe, but that means that they don't get paid
If in return for being on the frontline of the healthcare system they're quarantines for exposure to a #COVID19 patient, they don't get paid
If in return for being on the frontline of the healthcare system they're quarantines for exposure to a #COVID19 patient, they don't get paid
5/ Many practices are trying to figure out televisits.
We @AledadeACO have done tech diligence, created an implementation toolkit, taken over implementation from swamped vendor, subsidized costs for 550 practices.
What about non-Aledade practices?
We @AledadeACO have done tech diligence, created an implementation toolkit, taken over implementation from swamped vendor, subsidized costs for 550 practices.
What about non-Aledade practices?
6/ @CMSGov actions to make switch to televists feasible are excellent, and there is a big increase in televisits to be sure, but
a) it's still a small portion of total
b) many payers still don't pay for it
c) no one is paying for implementation costs
d) IT DOESN"T PAY AS MUCH
a) it's still a small portion of total
b) many payers still don't pay for it
c) no one is paying for implementation costs
d) IT DOESN"T PAY AS MUCH
7/ As usual, follow @Travis_Broome for detailed policy understanding of the issue, but as he says:
"If a practice switches all their visits to telehealth 1:1 they will see a 30% decrease in revenue"
"If a practice switches all their visits to telehealth 1:1 they will see a 30% decrease in revenue"
8/ So what is the US doing RIGHT NOW for practices with low financial reserves that are struggling with lack of personal protective equipment, risking exposure and infection, dealing with new technology costs, dwindling billable visits?
SBA loans
SBA loans
9/ You are going to be hearing A LOT about the urgent need for a $240 BILLION bailout for hospitals in yet another stimulus bill to be passed imminently
There is nothing (yet) in the bill for primary care practices that are meant to be the first line of defense against #COVID19
There is nothing (yet) in the bill for primary care practices that are meant to be the first line of defense against #COVID19
10/ If primary care practices close because of this-especially in rural communities-there will be no capacity for either outbreak detection, or for primary care for patients struggling every day with chronic diseases
The unanticipated death toll could be much higher than #COVID
The unanticipated death toll could be much higher than #COVID
11/ I don't usually do this, but I'm asking for your help.
if you have followers, tell them about this.
If you're a journalist, look into this
If you care about primary care, tag your senator or member of congress
There are simple things we can do to avert this disaster:
if you have followers, tell them about this.
If you're a journalist, look into this
If you care about primary care, tag your senator or member of congress
There are simple things we can do to avert this disaster:
12/ In a "Stimulus Bill" we MUST include support for frontline practices. It's moving quickly, and I don't know when there will be another chance, if ever
This string has details on what physician orgs are asking for.
simple/fast: primary care fee bump
This string has details on what physician orgs are asking for.
simple/fast: primary care fee bump
13/ There are also more that @CMSGov @SeemaCMS @CMSinnovates could bring to bear on this even without congressional action.
*Increasing facility portion of televists
*Paying portion of anticipated shared savings checks now
*fixing "rural glitch"
*enabling "tele-AWV" (home BP)
*Increasing facility portion of televists
*Paying portion of anticipated shared savings checks now
*fixing "rural glitch"
*enabling "tele-AWV" (home BP)
14/ For primary care practices even as you try to salvage your fee-for-service business this should be another reason to consider value-based pay
You can think of it as hedging your bets or diversifying your revenue, but being paid only for visits billed is bad business for PCPs
You can think of it as hedging your bets or diversifying your revenue, but being paid only for visits billed is bad business for PCPs
15/ Getting recurring revenue (per member per month) for quality outcomes is great, managing to switch to capitated primary care payments provides more security, but the real game-changer is getting paid for better outcomes/ fewer hospitalizations, no matter how they're achieved
The stimulus draft lifts the 2% sequester, has some funding for uncompensated care, but
*it is not specific to ambulatory care- could see most of it go to hospitals
*assumes practices can carry costs and be reimbursed later
*doesn't solve problem of practices can't see patients
*it is not specific to ambulatory care- could see most of it go to hospitals
*assumes practices can carry costs and be reimbursed later
*doesn't solve problem of practices can't see patients
Medicare is not paying an originating site fee on most of these visits so doing this won’t even cost @CMSGov more money and it would be a lifeline to physicians across the country who are trying to care for and protect their patients all at the same time.
A petition calling on Congress to support independent practices by providing economic relief, set aside funds for small practices who need financial support to ensure they are able to continue to serve their communities change.org/p/congress-pet…
We sat with one of our practices as they tried to apply for @SBAgov loan
They need to document-for every one who owns>20%
Tax returns
real estate owned
mortgage balance, account number
Deeds/leases
details on any notes payable
every stock or bond, what is was bought for and when
They need to document-for every one who owns>20%
Tax returns
real estate owned
mortgage balance, account number
Deeds/leases
details on any notes payable
every stock or bond, what is was bought for and when
