Letter to HHS Secretary Azar asks for enough to offset 80% of lost revenue

WASHINGTON —The American College of Physicians (ACP) sent a letter to HHS Secretary Alex Azar urging the agency to allocate emergency funds to help keep primary care practices afloat in the wake of the Covid-19 pandemic.

“ACP has heard from many internal medicine specialists providing primary and comprehensive care to patients that they are just weeks away from closing their doors, due to drastic declines in patient volume,” said ACP President Jacqueline W. Fincher, MD, MACP, in a statement. “Many small primary care practices, like mine, are struggling to make ends meet in this unprecedented public health emergency.”

In the letter, Fincher suggested that HHS make a targeted allocation out of the Provider Relief Fund (PRF) to primary care prectices in order to cover lost revenue caused by the pandemic, similar to HHS’s targeted allocation of $10 billion for rural hospitals that are struggling due to patient declines and the cancellation of elective surgeries. The organization requested that this allocation be enough “to offset at least 80 percent of total lost revenue from all payers, including Medicare, Medicaid and commercial insurers, from April 1 through the end of the calendar year, after taking into account disbursements already received by such practices from the general PRF allocations.”

Fincher noted that this allocation should also include funds to help cover the increased costs of personal protective equipment and other medical supplies associated with the Covid-19 pandemic.

Fincher also urged HHS to provide more options to allow primary care physicians to transition from fee-for-service (FFS) models by offering per-patient per-month (PPPM) prospective payments.

“The Covid-19 pandemic has shown the inherent flaws of FFS as a way of compensating primary care physicians, because revenue depends on being paid for a specific visit and procedure; as the volume of visits and procedures decline, primary care physicians and their practices are unable to bring in the revenue to keep their doors open,” Fincher wrote. “ACP has long-supported programs such as those from the CMS Innovation Center to provide PPPM payments to primary care. While completely eliminating FFS may not be viable for all practices now, we strongly encourage voluntary expansion of models to make PPPM payments to primary care adjusted for patient demographics—and provided more detailed recommendations for how this could be done in our April 28th letter.”

Fincher added that HHS should prioritize disbursements of PRF funds to internal medicine subspecialty practices, smaller practices, and practices in underserved urban and rural areas.

“Internal medicine specialists and other primary care physicians have an essential role in delivering primary, preventive, and comprehensive care not only to patients with symptoms or diagnoses of Covid-19, but also to patients with other underlying medical conditions, including medical conditions like heart disease and diabetes that put them at greater risk of mortality from Covid-19,” Fincher wrote. “Many studies have shown that the availability of primary care in a community is associated with reduced preventable mortality and lower costs of care, yet recent surveys suggest that many primary care facilities will soon close without additional support. They must be supported.”

John McKenna, Associate Editor, BreakingMED™

Cat ID: 192

Topic ID: 86,192,556,730,933,190,926,192,927,151,928