Hospitals and providers face unprecedented financial pressure amid the COVID-19 pandemic.
Providers are losing $1.4 billion daily as they experience significant declines in patient volume, according to consulting firm Crowe. Healthcare executives are responding to the financial declines with workforce reductions, pay cuts and other cost-cutting measures.
Debbie Zimmerman, MD, Corporate CMO at Lumeris, a value-based managed services company, and Essence Healthcare, a Medicare Advantage health plan with 64,000 members, stated that COVID-19 has shed light on the limitations of fee-for-service reimbursement when unmitigated risk is involved.
“If a primary care physician’s revenue is based on seeing patients face-to-face and that ability is taken out of the equation, it reflects a problem in the business model,” Dr. Zimmerman said.
To prevent future losses, healthcare executives are also reevaluating their participation in risk-bearing alternative payment models. In an April survey from the National Association of Accountable Care Organizations, which represents 180 ACOs, the majority — 80% of respondents — said they were very concerned about their ACO performance because of COVID-19. It is important to note, the survey was taken prior to CMS announcing an emergency rule that delivers relief to ACOs.