May 3, 2020

Reduced Patient Volumes from COVID-19 Strain Medical Practices

Indiana physicians concerned for patients delaying care

INDIANAPOLIS – The Indiana State Medical Association released a report today that describes a significant drop in patient visits with people delaying care and putting themselves at risk for worse outcomes. The study also highlights the economic strain medical practices are under due to the public health emergency caused by the novel coronavirus.

While every sector of the economy has been impacted by COVID-19, ISMA is concerned that further harm to local practices may hurt Indiana’s short- and long-term efforts in sustaining public health.

The ISMA COVID-19 Business Impact Report is based on a survey completed by ISMA members in partnership with the Indiana Medical Group Management Association (IMGMA). With more than 8,500 members, ISMA set out to determine the current and future effects of the stay-at-home order and other social distancing requirements to prevent further exposure to the virus.

“From the onset of COVID-19, we expected the surge would impact all physicians in Indiana, whether doctors were working on the front lines or not,” said ISMA Executive Vice President Julie Reed, JD. “What we couldn’t predict was the impact on all patients, including those suffering from chronic, non-COVID related illnesses, who would stop seeking treatment because they were afraid of getting infected.”

Steve Freeland, member of the IMGMA board of directors, agrees. 

“As CEO of one of the premier oncology groups in the Midwest, I can tell you that patients haven’t stopped needing cancer treatments during COVID-19,” said Freeland. “People don’t stop having heart attacks or requiring important screenings, either. It’s imperative that our specialty and primary care physician practices remain afloat, so Hoosiers have access to quality care both during the public health emergency and after it subsides.”

The report identifies the consequences from the pandemic for ISMA member practices, including solo or small practices, larger physician groups, specialists and primary care.

Patient Volumes and Revenues: More than 80% of practices report a decrease of more than 40% in patient volumes and associated revenues. Some respondents mentioned an 80% to 90% loss in revenue and the potential closing of their practices.

Health Care Staffing: Just over 70% of practices report reducing staff hours or positions. Slightly more than 50% of practices anticipate reducing staff positions over the next several weeks to two months if reductions in patient volume continue.

Financial Support: Over 50% of the practices have already applied for the U.S. Small Business Administration’s Paycheck Protection Program for emergency funding to support payroll and some overhead expenses, while another 25% state they are likely to or might apply for this program.

Telehealth Use: To adapt to public health directives and ensure patients still receive care, 71% of the practices report they are using some form of telehealth, including telephone only, video or a combination of these through telehealth platforms.

The results of the report show two potential risks that are interrelated, one to the economy if physician offices continue to struggle, and one to population health if people continue to delay treatment.

According to the American Medical Association, physicians in Indiana are a major driver of the state economy, spurring economic growth and creating jobs. Data from 2018 shows more than 157,000 Hoosiers are employed due to physicians in medical services, pumping $26.4 billion into Indiana’s economy and contributing $895.8 million to state and local tax revenue.

“While these medical practices contribute to the economic health of our state, their viability will also ensure patients have access to the preventive treatment and services that are important to the health of Hoosiers,” said Dr. Lisa Hatcher, MD, president of ISMA. “It is vital that health care providers across the state turn to innovative approaches to reach their patients.”

In March, Gov. Eric Holcomb took steps to encourage social distancing and allowed flexibility in the use of telehealth, something that ISMA strongly advocated for.

“ISMA fully supports Governor Holcomb and his administration for their decisive and effective leadership,” added Hatcher. “The policy changes directed from the governor’s office have protected Hoosiers during the pandemic and saved lives.”

The public health response, while effective, has led to unintended consequences for patients and their doctors’ offices. Notably, canceled elective procedures and missed appointments that resulted in the delay of screenings and diagnoses.

Although physicians are relieved that elective procedures are gradually being reintroduced through recent executive orders, Hatcher noted that the lack of personal protective equipment could still be a barrier. In addition, patient volumes will likely remain lower than normal due to COVID-19.

“It is important for Hoosiers to know that regardless of stay-at-home orders, they should still communicate with their doctors,” said Hatcher, a physician specialist in family medicine with obstetrics. “Your doctor and their teams are there for you and will make sure you get the care you need in a safe and timely manner.”


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About ISMA:
With 8,500 members, the Indiana State Medical Association (ISMA) is the largest physician organization in the state and is dedicated to maximizing physician impact. Learn more about ISMA by visiting ISMA's website or following ISMA on Twitter and Facebook.

Media Contact:
Steve Cooke
(317) 627-9955