There’s certain news that’s almost guaranteed to get practice management readers interested.
So, we decided to take a step back and look at some of the top stories of the year that got practice management leaders reading. Take a look below.
1. Salaries
No surprise here. Every year, our salaries stories are by far our readers' favorites as we watch which specialties are the highest paid, which docs have seen the biggest pay increases or even which regions of the country are best for physician pay.
The big story this year? Just how much, on average, in pay drops doctors have seen this year amid stay-at-home orders cutting revenue while costs soared during the COVID-19 pandemic.
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2. Disruption at all levels
Another major storyline docs are following this year? The continued disruption of the primary care model accelerated by the challenges of the pandemic.
Startups Firefly Health and Galileo as well as more established telehealth players such as Doctor on Demand, MDLive and Teladoc have rolled out virtual-first primary care offerings to payer and employer customers. Digital health company Hims and Hers also has jumped into the space as it fast-tracked an expansion of its telehealth services to offer access to primary care.
Other players making moves are One Medical, Iora Health, Privia Health and VillageMD, which have each raised capital and are leading the evolution of primary care.
But some of the biggest disruptions have been coming from major players like Walmart Health, which has been building out clinics across the U.S. as well as partnering with value-based care primary care group Oak Street Health to create some of its clinics. Earlier this year, Amazon teamed up with trendy tech-enabled primary care group Crossover Health to launch health centers near its fulfillment centers and operations facilities.
3. Teleheath
While much of the disruption above comes in the form of virtual options, the rapid jump physicians' practices had to make to telehealth platforms and virtual care delivery is the central story of the year.
As of July 2020, 80% of U.S. physicians had conducted a virtual patient consultation in the previous three months—up from 39% in April and 9% in early March, surveys found.
In a bid to support practices forced to jump to telehealth platforms to deliver care amid stay-at-home orders, the Centers for Medicare & Medicaid Services (CMS) agreed in March to pay for virtual visits at the same rate as in-person visits while the coronavirus emergency remains in effect. CMS also agreed to pay physicians for patient visits that take place by telephone to help practices stay open by providing them with needed revenue.
CMS has since moved to permanently expand telehealth services for rural areas beyond the COVID-19 pandemic, but it will need congressional approval for full-scale expansion.
4. CMS finalizes physician fee schedule, including controversial updates to E/M visits
In December, the Trump administration finalized the annual regulation governing physician payments, and in the rule approved payment adjustments to evaluation and management visits that drew ire from docs.
The changes to E/M visits would boost payments for these services, with the goal of empowering physicians to intervene more quickly to catch complex conditions and better manage patients' health, CMS Administrator Seema Verma said.
However, the physician fee schedule is required to be budget neutral, leading to decreases elsewhere, with some physician specialties facing double-digit decreases in payments for 2021.
When these changes were initially proposed in the summer, they drew sharp criticism from physician groups. The American Medical Association (AMA), which pushed for the payment increases for E/M visits, urged the agency to waive the budget neutrality requirement in this case.
The decreases, the group said, would represent an 11% cut to the Medicare conversion factor.
Physician organizations also warned that cuts could be felt even more strongly as the COVID-19 pandemic does significant damage to their finances. Similar pushback to the final rule is likely.
5. Response to social and racial injustice
Another area in which the pandemic shown a glaring light is the role healthcare had to play in combating racial inequality as non-white patients suffered disproportionately from the COVID-19 virus. Studies even found healthcare workers of color were more likely to get COVID-19.
Several healthcare groups, including the American Association of Medical Colleges, called racism a "public health concern." As docs across the country joined protests across the country over police brutality following the death of George Floyd in police custody in Minneapolis, the AMA board pledged action against racism.