As patients slowly return for in-person visits, volumes and revenue remain a major focus for medical practices

MGMA Stat - May 11, 2020

Patient Flow

Patient Access

Population Health

MGMA Staff Members


The Medical Group Management Association’s most recent MGMA Stat poll asked medical practice leaders, “Have you reopened your practice to patients in person?” The majority (89%) responded “yes,” while 11% indicated “no.” 

Respondents whose practices have reopened amid COVID-19 were then asked, “What percentage of your providers are seeing patients in-person?”  

  • More than half (54%) reported 100% of their providers are seeing patients in person, while 20% said 76% to 99% of providers were seeing patients in person and 9% reported that 51% to 75% of providers have in-person visits. 

  • Only 18% of respondents said that 50% or less of their providers were seeing patients in person after reopening. 

  • Numerous respondents with 50% of normal provider capacity noted that providers are alternating weeks and keeping schedules half full, and that patient loads remain much lower than pre-COVID-19 norms. 

  • Many practice leaders report their providers are still predominantly handling telehealth appointments, either via virtual visits or telephone visits, and that patient throughput in the clinic remains much lower. 

The poll was conducted May 8, 2020, with 1,122 applicable responses. 

The importance of bringing patients back 

The slow increase of in-office patient visits amid lifting stay-at-home orders offers a glimmer of hope, but medical practices remain a long way from returning to normal, especially after seeing an average 55% decrease in revenue and 60% decrease in consumer volume, according to an April MGMA Government Affairs survey

Anders Gilberg, MGA, senior vice president, MGMA Government Affairs, says that many MGMA members are hearing from patients about their concerns over coming back to a doctor’s office. This represents a clear imperative for practice leaders to build patient education efforts into their reopening strategies. This will help minimize the number of patients foregoing necessary care, the effects of a backlog for providers in the future and the potential negative outcomes from deferred attention to important health issues. 

May 1-4 COVID-19 primary care survey from the Primary Care Collaborative underscores the concerns for patients putting off visits to the doctor: 

  • More than 60% believe some patients will have avoidable illness due to deferred care. 

  • About 56% believe primary care clinics will be overwhelmed by a backlog of health needs. 

  • About 74% expect an increase in patients with mental health needs. 

Every dollar counts amid lower volumes 

The still-diminished visit volumes can have serious impacts for physician practices. As reported by Jack O’Brien of HealthLeaders, the leader of an independent multispecialty clinic in Washington State called the situation “an uphill battle” in terms of financial losses from the shutdown and slow reopening. 

“In the month of March, our losses were over $3.5 million and in April, we expect the losses to be between $10 million to $15 million," noted Mark Mantei, chief executive officer of the Vancouver Clinic. 

For practices still largely in a fee-for-service (FFS) model, those losses will weigh heavily for as long as volumes are slow to return to pre-COVID-19 levels. As reported by RevCycle Intelligence, practices that have embraced certain value-based arrangements to be paid on a “prospective, capitated payment that is risk-adjusted” are faring better than FFS-heavy practices, according to Rebecca Etz, PhD, co-director of The Larry A. Green Center. 

Additionally, as practices continue to navigate federal financial assistance options, many uncertainties remain around the loan forgiveness terms for the Small Business Administration’s Paycheck Protection Program (PPP). MGMA Government Affairs recently sent a letter to SBA’s administrator asking for further guidance on loan forgiveness so medical practices can make informed decisions about how to spend their loans. 

Resources 

MGMA STAT 

Would you like to join our polling panel to voice your opinion on important practice management topics? MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at: mgma.com/stat

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