Study finds slight rebound in patient volumes in May, but physicians still in danger financially

Visits to ambulatory care practices have rebounded slightly since early April, but physicians still face major hurdles to get back to pre-pandemic levels, a new study found.

The study, published Wednesday by the Commonwealth Fund, comes as physician practices have faced major revenue hits due to the pandemic. Providers also called for targeted relief for primary care physicians to help them recover.

The Commonwealth Fund updated data released April 23 that showed the number of visits to ambulatory care practices declined by nearly 60% as of March 29 compared with pre-pandemic levels. But a new update found the number of visits rebounded slightly to below 30% as of May 10.

The rebound occurred across all specialties, although the decline in visits remains largest among surgical and procedural specialties alongside pediatrics, the study said. While the rebound is occurring in all areas, the southern central region comprised of Texas, Oklahoma, Arkansas, Louisiana, Mississippi, Alabama, Tennessee and Kentucky had the largest increase in visits.

Several of those states, such as Texas and Oklahoma, have moved to reopen in recent weeks.

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In an interesting twist, the rebound in visits is due to more in-person visits than telemedicine use.

Telemedicine visits skyrocketed during the pandemic. The number of telehealth visits in a given week were zero percent on March 8 but increased to 14% as of April 19.

But telehealth visits have plateaued recently as in-person visits have increased, the study said.

The data are based on several sources that include check-in information submitted via patients on a platform created by healthcare technology company Phreesia, which has clients that represent more than 50,000 providers.

Providers say the data underscore the need for more funding to help primary care physicians recover from the pandemic.

Practices that continue to stay open have to deal with new operating costs as the pandemic continues, including setting up a separate entrance for testing, said Farzad Mostashari, M.D., co-founder and CEO of Aledade, a company that partners with primary care physicians to help them become accountable care organizations.

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He added that Congress needs to allocate $15 billion specifically for primary care physicians.

“We need to throw these practices a lifeline right now,” he said on a call Wednesday with reporters about the new study.

While Congress has appropriated $175 billion to providers, nothing has been specifically targeted or dedicated to primary care.

The Department of Health and Human Services initially gave out $30 billion based on historical Medicare spending, which does not help providers that rely primarily on other sources of revenue.

More help is also needed as a second wave of the virus could come this fall, said Melinda Abrams, senior vice president of delivery system reform and international innovations for the Commonwealth Fund.

“An investment in primary care now ensures that we have primary care,” she said. “We are worried about its collapse.”