COVID-19 Recovery Requires Staffing Stability, Patient Engagement

As healthcare organizations recover from the significant strain of COVID-19, a Medical Group Management Association (MGMA) special report outlines healthcare leader insight on how practices can rebuild to pre-pandemic patient volumes and revenues through staffing stability, patient engagement, and telehealth.

The "Quantifying COVID-19: Measuring the Pandemic's Impact on Medical Practices” report is based on a year’s worth of quantitative data from 142 groups and 1,252 providers who participated in the MGMA 2020 monthly survey, as well as interviews with healthcare leaders.

"The data tells the story of a very challenging time in history and how quickly and creatively a majority of practices were able to pivot and survive," Andrew Swanson, MPA, CMPE, vice president of Industry Insights at MGMA, said in a press release.

"To sustain patient care and volume, support staff working remotely, enhancing safety procedures, and embracing telehealth, practice leaders and healthcare workers adapted to extraordinary levels to overcome the pandemic's impact,” he continued.

According to interviews with healthcare leaders, practices should focus on responding quickly and effectively to government aid. . Furloughs and layoffs were less likely to occur at medical groups and practices that swiftly took advantage of federal emergency relief efforts, such as PPP loans.

Healthcare leaders also noted that maintaining staffing stability is key on the road to recovery from COVID-19. Practices that secured PPP loans were able to see lower turnover rates, which in turn allowed practices to schedule in-person visits that still allowed for social distancing. Those leaders were also able to split teams so that there were always care team members away from the office in case a provider or staff member had to quarantine.

Next, industry leaders said that practices must determine the most efficient way to integrate telehealth into day-to-day operations.

They noted that many practices with higher levels of in-person care over the course of 2020 reported success mixing in-person and virtual visits for physicians working in the clinic. Other healthcare leaders interviewed by MGMA said that scheduling entire days of telehealth visits for providers working from home was optimal for many physicians.

Administrative healthcare leaders also expressed the importance of reimagining patient payments and collections.

“Multiple practices reported either 30- or 60-day pauses on collections at various points in 2020, which gave them time to look at their A/R and update their payment plan offerings,” the report authors explained.

Maintaining patient engagement is also key as the healthcare industry recovers from COVID-19, the industry leaders said.

“While telehealth services (e.g., video visits, audio visits, remote patient monitoring) were a lifeline for many practices in the early months of the pandemic, administrative leaders said that keeping communications open with their patients and giving them a sense of security around in-person visits, procedures, and services was what drove improved productivity and revenues toward the end of 2020,” the report authors wrote.

Lastly, healthcare leaders expressed the importance of “taking care of each other” through the tumultuous COVID-19 pandemic. Practice leaders, especially in human resources positions, significantly ramped up their focus on employee well-being throughout 2020.

The quantitative report highlights data benchmarks that can aid healthcare leaders on the path to pre-pandemic levels.

Specialist physicians (surgical and nonsurgical) saw the greatest decrease in compensation during the onset of COVID-19 and through the summer compared to any other physician type.

According to the report, the suspension of surgeries and elective procedures contributed to low specialist volumes. Additionally, COVID-19 care demands at affiliated hospitals led to a decrease in referrals and specialist compensation.

Primary care providers (PCPs) also saw significant drops in compensation during March and April 2020. However, telehealth expansion largely restored patient volumes and corresponding compensation later in the spring.

Total operating costs decreased among medical practices nationwide during the COVID-19 pandemic. Many practices experienced revenue losses from the decline in patient visit volume while simultaneously experiencing increased costs as the demand for sanitation supplies and PPE surged.

An August 2020 MGMA Stat poll found that the vast majority of healthcare leaders (98 percent) reported an increase in the total cost of obtaining PPE. For 15 percent of the practices that faced higher PPE costs, expenditures for PPE increased by more than 100 percent compared to the previous year.

According to the report authors, limiting in-person visits and spending cuts (including layoffs and furloughs) likely mitigated the overall impact of the skyrocketing cost of PPE.

The report also revealed that COVID-19 took a significant toll on the physician workforce; more than one in four (28 percent) of healthcare leaders reported an unexpected physician retirement in 2020. Therefore, the experts noted that 2021 will continue to be a year of recruiting new physicians.

Additionally, the report noted that many practices are expected to introduce advanced practice providers (APPs) into their practice this year.

“Cost-conscious practices looking to grow and meet increasing levels of patient volume are likely to consider the addition of advanced practice providers (APPs) to their care team models,” the report authors wrote. “A November 5 MGMA Stat poll found that more than half of respondents reported that they were planning to add APPs to their practice in 2021.”