MMA study shows bottom line health care impact of COVID-19

Staff Writer
Redwood Falls Gazette
Nearly three-quarters of physicians said they think it is important to retain telehealth as a care delivery method.

Minnesotans experienced adverse health outcomes due to delays in care, the use of telehealth has surged, the bottom lines of physician practices in Minnesota were hurt significantly during the first months of the COVD-19 pandemic and doctors fear the next wave of the virus.

These are a few of the key findings of a recent study commissioned by the Minnesota Medical Association (MMA) on the impact of the pandemic on physician practices.

The study, “Minnesota Physicians Respond to COVID-19,” is based on responses to two surveys – one sent to Minnesota physicians and one sent to medical practice administrators.

The surveys were completed between June 16 and July 13, 2020.

“Given how quickly the health care world is changing during this pandemic, we realize these results are just a point in time,” said Keith Stelter, MMA president, “but they do confirm a lot of what we’ve been hearing anecdotally – even for patients without COVID-19, their health is suffering, the pandemic has accelerated use and acceptance of telehealth by both patients and physicians and there are serious concerns about what happens with the next wave.”

Delayed care

More than 50 percent of physicians reported that their non-COVID patients experienced adverse outcomes due to care delays. Specifically, 19 percent of physician respondents reported patients had delayed routine or preventive care, 17 percent of respondents said their patients feared seeking care because of potential exposure to the deadly virus and 5 percent reported that care delays caused a patient death.

“Several elderly patients have put off their patient appointments and had significant worsening of their pain issues,” said one responding physician. 

“The results of this survey confirm our concerns regarding patients avoiding care because of their fear of the virus,” Stelter said. “It’s one of the main reasons we’ve continued to encourage Minnesotans to seek care during the pandemic as part of our practice good health campaign.”

Telehealth use grows

Not surprisingly, the use of technology increased dramatically during the pandemic, the study found.

In 2019, practice administrators reported that approximately 3 percent of patient encounters were conducted via telehealth including e-visits, phone and video visits. Since March 2020, that number has increased to 28 percent, an increase of 833 percent.

Eighty-four percent of physicians reported patients were satisfied or very satisfied with telehealth visits. A similar proportion of physicians (83 percent) said telehealth is meeting the care needs of their patients.

Nearly three-quarters of physicians said they think it is important to retain telehealth as a care delivery method, but changes are needed for that to continue.

Seventy-eight percent reported uncertainty around ongoing reimbursement by insurers as a barrier to broader telehealth adoption and use.

Another critical barrier to telehealth adoption is on the patient side – 73 percent of physician respondents noted that patient access to technology and patient access to broadband (60 percent) were moderate to significant barriers to broader telehealth use.

“We’re glad to see the expanded use of telehealth,” Stelter said. “However, not all patients can currently access it. Many Minnesotans don’t have access to broadband. Variation in technology platforms can also drive patient comfort and use. For telehealth to be truly helpful, everyone needs to have the ability to use it effectively. This is yet another example of the health care disparities that exist in Minnesota.”

The bottom line

The research found, overall, medical practices saw professional service volume and revenue decline by more than 45 percent for the period March 16 to May 10, compared to same period in 2019. Non-primary care single specialty practices were hit the hardest, reporting a 76 percent decrease in median volume and revenue.

The pandemic has affected earnings for both physicians and other health care workers.

Ninety-one percent of physicians reported that they experienced reductions in their cash compensation and/or benefits. Ninety-six percent of organizations reported that they implemented reduced hours, furloughs, layoffs, terminations and/or hiring freezes for non-physician staff.

The survey also found a large percentage of medical practices accessed financial assistance, be it through federal sources or a private loan or grant. The most common assistance was the federal Paycheck Protection Program, which was used by 73 percent of organizations.

Although respondents say they expect business to increase during the second half of 2020, they do not expect it to match 2019 levels. Fear of the next wave Administrators and physicians alike said they are concerned about a second wave of COVID-19.

Ninety percent of administrators and 81 percent of physicians said they were concerned about their organization’s ability to withstand a second wave of the virus.

More than a third of administrators and physicians noted the need for additional financial support if the state faces a second wave of the pandemic. Twenty-one percent also said they were concerned about having enough PPE for a second wave.

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