TRENDS
BY MARK THILL
A Bridge in Time Federal relief efforts were lifesavers for many providers during COVID-19. What lessons have they learned from the experience?
hospital system, and having the federal govt specifically exclude me in COVID-19 workplace benefits (FFCRA). Pretty much a nightmare.” – Texas
ʯ “Insecurity, exhaustion, moral outrage, despair, grief, rage, despondency. Seriously questioning whether to continue to stay and serve a society that doesn’t seem to value me, my loved ones, or what we do. Currently working ~120 hrs/ wk providing unfunded care at my own personal expense to gravely ill persons. I have maxed out my own resources and reserves.” – Colorado On March 27, 2020, President Trump Statistics provide the bones of the story. But words provide the flesh.
signed into law the $2.2 trillion Corona-
Medicare spending for physician services dropped as much as 57% below expected
virus Aid, Relief and Economic Security
pre-pandemic levels in April 2020, according to the American Medical Association.
Act, also known as the CARES Act. For
Medicare Physician Fee Schedule spending at the end of June 2020 was still 12% less
healthcare providers, the Act expanded
than expected. During the first half of 2020, the cumulative estimated reduction in
the Medicare accelerated payment pro-
Medicare physician spending associated with the pandemic was $9.4 billion (19%).
gram, in essence, giving physicians an
Expenses spiked while revenues dropped. Impacts on total spending for the first six
advance on future Medicare payments.
months of 2020 ranged from a 6% reduction for nephrology to a 29% reduction for oph-
Through the CARES Act, the Paycheck
thalmology and a 34% reduction for physical therapists. At the state level, impacts ranged
Protection Program (PPP) and Health
in aggregate from a 13% reduction in Oklahoma to a 27% reduction in New York.
Care Enhancement Act, the federal government allocated $178 billion in payments to be distributed through
Now, the words of clinicians, describing
ʯ “Lower salary for more work, risk
the “new normal,” from a survey spon-
of serious illness every day, doing
healthcare providers. The Consolidated
sored by the Primary Care Collaborative
my staff ’s jobs because they are
Appropriations Act, 2021, passed into
in July 2020:
afraid to touch and be in the room
law on Dec. 27, 2020, allowed eligible
ʯ “More telehealth, lots of stress about
40
the Provider Relief Fund (PRF) to
with patients, spending my own
businesses – including eligible providers
patient numbers, angry/exhausted
money ($30k) on PPE for the entire
– to receive a second PPP loan, referred
coworkers.” –New York
clinic despite working for a huge
to as a “second draw.”
October 2021 | The Journal of Healthcare Contracting
