Primary care docs note equipment shortages, worsening patient health amid pandemic

Medicare Advantage enrollees in 4-star or higher plans to drop in 2021

Dive Brief:

A majority of providers said patient health has noticeably worsened during the COVID-19 pandemic due to delayed or inaccessible care, according to a new survey from the Larry A. Green Center and the Primary Care Collaborative.
The clinicians said they are also confronting their own problems, particularly with the supply chain. More than a quarter say they had inadequate access to COVID-19 testing while 14% say they lack appropriate personal protective equipment.
Those physicians are also struggling to replace practice members and fill open positions. Among those who have faculty positions, 80% said their ability to teach has been impaired while 27% say they have delayed or canceled work sessions with students.

Dive Insight:
The COVID-19 pandemic has dealt a serious hit to both the operations and bottom lines of physician practices. The Larry A. Green Center and the Primary Care Collaborative has been quantifying the impact through monthly surveys of medical practices that have painted a picture of practices under huge amounts of stress not only with treating patients, but also figuring out how to stay afloat.
Its most recent survey, conducted in mid-October among 582 physicians, notes 85% said they have also seen a significant deterioration in their patients’ mental health.
“The amount of patients with mental health concerns right now is significant. There is great difficulty in helping them access behavioral health services,” said a physician who practices in Illinois.
Telehealth has provided a partial solution: 64% say it has been important regarding accommodating patients; 38% use video visits for at least one in five of their patients; and 35% use telephone visits at about the same rate. Nearly 70% use telehealth to manage chronic conditions while 61% use it for mental health visits.
However, practices are also struggling to maintain proper equipment levels. While 23% say they have seen an increased demand for the current influenza vaccine, 10% still have not been able to obtain any. And the lack of PPE has led 23% to say they feel unsafe at work.
Perhaps partly as a result, many personnel are actually leaving medical practices. Among those surveyed, 27% say they have lost practice members due to early retirements or illness while 35% say they cannot fill open staffing positions.
The pandemic has prompted some practices to become more socially engaged. Nearly a quarter of the practices surveyed said they have increased their connections with community organizations and 27% say they have become more involved in helping patients access food, housing and job opportunities.
Even as it appears the world is inching toward developing and distributing a COVID-19 vaccine, the physicians surveyed say their patients are cautious about such a development.
“Patients are leery of any rushed (COVID-19) vaccine. Patients would rather have a well vetted vaccine next year than a rush vaccine this year,” said a Pennsylvania physician. Another doctor in Tennessee was blunter: “Most say they will not take a vaccine unless [National Institute of Allergy and Infectious Diseases Director Anthony] Fauci says it’s safe.”
As a result, the survey authors concluded that the “successful distribution of a COVID-19 vaccine will require a high functioning primary care platform, yet practices remain weakened by lost revenue, pandemic surges, and deteriorating patient health. It is urgent that public and private payers foster primary care stability by committing to prospective payments and maintenance of telehealth at parity with in-person visits through December 2021.”

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