Doctor's office Some healthinsurers are offering advance payments to providers to help keepthe doors open, but even those measures are a Band Aid for a largerproblem that needs to be addressed. (Photo: Shutterstock)

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Across the country, businesses are suffering. Whether it'sclosure due to stay-at-home orders, decreased demand, increasedsupply costs or a shortage of key materials, very few industriesare immune to the COVID-19 pandemic. Some businesses won't reopenwhen the rest of the economy does, and some jobs and industrieswill never look the same.

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One sector in particular that is at risk of going away: primarycare providers. While the financial plight of hospitals and majorhealth systems has been well documented over the past few months,independent and smaller primary care providers have been strugglingin relative silence.

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Related: Health care industry saw 43,000 layoffs inMarch

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"Primary care has actually gotten decimated by COVID," MikeThompson, president and CEO of the National Alliance of HealthcarePurchaser Coalitions said in a recent webinar. "We've had calls at thenational level from groups that are very concerned about survival.Volume is down, they're not getting reimbursed in thefee-for-service well. Even telehealth reimbursements aren't thesame."

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Like other businesses, lack of patients and income could spelldoom for smaller primary care providers, many of whom may be forcedto close down. Others, however, could be bought up by larger primary careproviders or health systems. "We can't afford to lose this primarycare infrastructure, or small practices being acquired by largesystems, because prices are going to go up," said Ann Greiner ofPrimary Care Collaborative.

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Some health insurers, such as Blue Cross Blue Shield of Arizona, are offeringadvance payments to providers to help keep the doors open, but eventhose measures are a Band Aid for a larger problem that needs to beaddressed. Panelists pointed to the need to break free from afee-for-service model and to fight for improved reimbursement ratesfor providers–particularly when it comes to telehealth.

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"Within a couple of weeks, providers did this pivot to virtualhealth," Greiner said. "And yet there is not proper remunerationfor that. Private plans should step up and start paying fortelephonic visits. Telehealth is helping to meet patient demand,but it's not successfully meeting all patient demand."

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The need to support and reform the primary care model willbecome more apparent in the weeks and months to come. According tosurvey data, two thirds of primary care providers expect to see ahuge unmet demand for mental health services, as well as increaseddemand for preventive care, chronic care, substance abuse treatmentand domestic violence incidents.

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Covid impact on health graphic
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"This is really important to think about so that we can avoid asecond health crisis," Greiner said. "We have got to start payingattention to this care that is being delayed or avoided, both inchronic care and prevention but absolutely on the mental healthfront."

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For employers worried about their health care spending in yearsto come, the shortage of primary care essentially pulls the rug outfrom under them. Without early intervention, chronic conditionswill become more common and costly. In addition, health careindustry leaders are already expecting to see a surge in late-stagecancer as a result of delayed screenings and doctor visits.

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"The next stimulus package needs to have more targeted supportfor primary care," Greiner said. "Make sure that the doors are notclosed, virtually or otherwise. Private payers have to step up …private payers have to use some of the largess they have to advancepayments to primary care and make sure they remain variable,particularly the independents."

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Emily Payne

Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.