COVID-19 having impact on other patients, medical practice finances, survey says

Hoosiers have been delaying needed health care and putting themselves at risk for worse outcomes during the COVID-19 pandemic, according to a survey released Sunday by the Indiana State Medical Association.

While those delays have left the health care system in better shape to take care of COVID-19 patients, they’ve been taking a big toll on the economic condition of medical practices throughout the state, the survey says.

More than 80% of the medical practices that responded to the survey said they have experienced a decrease of more than 40% in patient volumes and associated revenue. Some respondents said they had suffered an 80% to 90% loss in revenue and were considering closing their practices.

Slightly more than 70% of the respondents said had reduced staff hours or employment at their practices. Of those, 26% have instituted temporary layoffs, and 3% have terminated employees altogether.

More than 50% of respondents said they expected to reduce staff over the next two months if reductions in patient volume continued.

The ISMA is the state’s largest physician organization in the state, with more than 8,500 members. Its survey was conducted from April 9 to April 26 and got responses from 550 members. The survey was conducted in partnership with the Indiana Medical Group Management Association.

The association said the report highlights two impacts from the pandemic and the related shutdown efforts: One to the financial condition of medical practices and one to public health if non-COVID 19 patients continue to delay treatment.

“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,” ISMA Executive Vice President Julie Reed said in written remarks. “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.”

More than 50% of the practices that responded applied for the U.S. Small Business Administration’s Paycheck Protection Program to help with payroll and overhead expenses, while another 25% were likely to apply or might apply for the program.

The ISMA said stay-at-home orders have been effective and had their full support, but led to unintended consequences for patients and their doctors—canceled elective procedures and missed appointments that have delayed screenings and diagnoses.

“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, chief executive of the Indianapolis-based Cancer Care Group and IMGMA board member., in written comments. “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 found many practices are adapting to the situation by implementing more technology. More than 70% reported using some form of telehealth platform.

Dr. Lisa Hatcher, president of ISMA, said doctors are relieved that elective procedures are picking up pace after the easing of executive orders. But she practices are still likely to be hampered for a while by the lack of personal protective equipment and lower-than-normal patient volumes due to COVID-19.

The ISMA said more than 157,000 Hoosiers are employed due to medical services, putting $26.4 billion into Indiana’s economy and contributing $895.5 million to state and local tax revenue.

“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.”