Since it was established in 2008, the Large Urology Group Practice Association has worked to advance independent practice while demonstrating care quality and value to patients, vendors, payers, legislators and regulatory bodies. That mission has only grown more important in light of the COVID-19 pandemic.
LUGPA President Richard Harris, MD, a Melrose Park, Ill.-based urology specialist, shared his thoughts with Becker's ASC Review on how independent practices will fare — and what can be done to help them survive — after the crisis subsides.
Note: Responses were lightly edited for length and clarity.
Question: What kind of long-term effects will the COVID-19 pandemic have on independent practices?
Dr. Richard Harris: Patient reception to telehealth visits has been favorable, and we expect patients to continue to seek them post-COVID-19. As such, we are hopeful that third-party payers will recognize the value of telehealth visits and that independent physicians will be able to continue providing them as an expanded service.
While independent urology practices have been nimble in making telehealth visits available to patients, telehealth visits alone will be insufficient to ensure practice viability in the long term as revenue and patient visits drop off. For smaller groups with older physicians or solo practitioners, this pandemic may be the time that they decide not to reopen their practices after the surge. If independent physicians were to all go out of business, increasing rates of hospital consolidation would leave patients with costlier, lower-quality care, further debilitating our healthcare system's capability to deliver the appropriate and adequate care patients desperately need and deserve.
Q: Will government aid be enough to keep independent groups afloat after the crisis?
RH: The government grants are helping many independent practices survive. However, difficulties in the initial round of funding for the Paycheck Protection Program left many groups not receiving funds — which caused independent practices to scramble to stay afloat during this crisis. Numerous independent practices have been forced to furlough staff, delay payments to physicians and undertake other extreme cost-cutting measures to survive. The longer the pandemic halts normal activity, the more difficult it will become to sustain practices. As such, additional governmental economic aid is essential to ensuring the continued provision of independent healthcare services in the U.S.
Q: What kind of other measures must be taken to help independent practices survive?
RH: While independent physician groups are appreciative of government support and efforts to sustain our viability, the revenue cycle in medicine has a two-month lag, meaning the current funds will only carry practices through mid-July. Unfortunately, from mid-July, throughout the summer, and probably into the fall and winter, all practices will have markedly reduced cash flow and will still be struggling to survive.
Before the pandemic, LUGPA had been focusing on various critical issues for independent practices, such as Stark Law and site-neutral payment reform. These issues are now even more essential in providing independent practices with the very security that COVID-19 threatens. LUGPA will continue to engage Congress and the administration to urgently address these issues as part of the reforms needed to ensure the viability of independent practice.
Q: Do you think we'll see more consolidation among independent groups as a result of the pandemic? Why or why not?
RH: The healthcare and economic crises precipitated by COVID-19 will certainly influence whether independent practices across the country can survive or continue to operate in a normal capacity. There is a real threat that hospitals may use government stimulus funds to buy out physician practices, increasing the upward trend of hospital consolidation. The acquisition of more physician practices by hospitals will not be a win for our patients; instead, it will only serve to further inflate the cost of medical care to patients. Additionally, hospital consolidation hinders access to care as it creates narrow networks that require patients to travel further to find in-network physicians. While the future is uncertain and we cannot predict whether this crisis will drive consolidation, LUGPA is dedicated to preserving and protecting independent practice, and we will continue our aggressive advocacy efforts to do just that.
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