Decrease in patient visits raises health concerns, strains practices
Details of the ISMA COVID-19 Business Impact Report, released Monday, are stark: Hoosiers under stay-at-home orders are not visiting their doctors to be assessed or treated for illnesses unrelated to COVID-19. Not only is this causing significant financial strain for physician practices, it is also increasing patients’ risk for negative health outcomes.

“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.”

The ISMA COVID-19 Business Impact Report is based on a survey of ISMA members conducted in partnership with the Indiana Medical Group Management Association (IMGMA). 

“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 Steve Freeland, an IMGMA Board member. “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 survey sought to determine the current and future effects of Indiana’s stay-at-home order and other social distancing requirements on Indiana physician practices and patients. Respondents included solo or small practices, larger physician groups, specialists and primary care. Notable findings include:

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 laying off staff or reducing staff hours. Slightly more than 50% of practices anticipate reducing staff positions over the next several weeks to two months if decreases 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 survey highlighted two interrelated risks created by the COVID-19 pandemic: one to the economy if physician offices continue to struggle and the other to population health if people continue to delay treatment.

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

Access to care essential
“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 ISMA President Lisa Hatcher, MD. “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 Gov. 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, Dr. Hatcher noted that the lack of personal protective equipment could still be a barrier to patient care. 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. “They need to know that their doctors and their teams are there for them and will make sure they get the care you need in a safe and timely manner.”

Read more about the report >>