Primary Care Practice Finances In The United States Amid The COVID-19 Pandemic

Health Aff (Millwood). 2020 Jun 25;101377hlthaff202000794. doi: 10.1377/hlthaff.2020.00794. Online ahead of print.


Due to the novel coronavirus disease (COVID-19), virtually all in-person outpatient visits were cancelled in many parts of the country between February and May 2020. We sought to estimate the potential impact of COVID-19 on operating expenses and revenues of primary care practices.Using a microsimulation model incorporating national data on primary care utilization, staffing, expenditures, and reimbursements, including telemedicine visits, we estimated that primary care practices over the course of calendar year 2020 would be expected to lose $67,774 in gross revenue per full time physician (the difference between 2020 gross revenue with COVID-19 and the anticipated gross revenue if COVID-19 had not occurred, interquartile range: -$80,557, -$54,990). We further estimated that the cost would be $15.1 billion at a national level to neutralize the revenue losses caused by COVID-19 among primary care practices. This could more than double if COVID-19 telemedicine payment policies are not sustained. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs.].

Keywords: COVID-19; Coronavirus; Cost reduction; Federally qualified health centers; Fee for service; Health policy; Pandemics; Payment; Physician payment; Physicians; Primary care; Telehealth.