For more information:
Contact: Bobby Hillert | 214.728.7672 m | Bobby@toa.org
TOA Highlights Measures for Business Partners to Help Medical Practices
April 8, 2020 – According to Modern Healthcare: “The healthcare industry’s 42,500 jobs lost in March amid the COVID-19 pandemic were almost entirely on the outpatient side. Hospitals added 200 jobs.” All types of medical practices – private practices, academic practices, and hospital-based practices – are facing the effects of lost revenue. Delayed and canceled services, such as surgery, have resulted in dramatic revenue drops for medical practices, and private practices have faced some of the biggest hits in the early stages of the pandemic.
An orthopaedic practice, for example, requires a high level of overhead to provide services to patients. Employees represent a large percentage of the overhead. Employees who handle patient care include x-ray technicians, physician assistants, physical therapists and nurses. Practices also feature employees who focus on administrative duties, such as those who address prior authorization requirements required by commercial health insurance plans. Other overhead includes the clinic’s building, surgery facilities, insurance, imaging, and other important capital equipment.
The COVID-19 pandemic has resulted in a dramatic drop in revenue, which is necessary to fund the overhead. The practices have made retaining employees their top priority, and many have responded by decreasing or eliminating physician salaries and seeking other cost-saving measures. However, some practices have had no choice but to lay off employees.
The financial challenges are not limited to private practices. Academic practices and hospital-based practices, for example, are also experiencing extreme revenue loss because overall case volume has decreased. An increasing number of media reports from across the country are highlighting layoffs being conducted by hospitals in response to the decrease in surgeries.
Business partners of orthopaedic practices are creating measures to help medical practices address their revenue deficits, and the Texas Orthopaedic Association (TOA) is recognizing those efforts to help medical practices during the pandemic. In addition, TOA is asking commercial health insurance plans to make modifications to help patients through this difficult time.
Requests for Commercial Health Plans
Many patients are suffering during this time, and commercial health insurance plans can help them once all surgeries are allowed in Texas again:
Waiving deductibles – Commercial health insurance plans should consider waiving deductibles and co-pays for surgery patients who have experienced surgery delays. Many patients are now facing financial distress, and they may have to further delay their medical care without financial assistance.
Authorization period – Many surgery cases were approved prior to the elective surgery ban. Commercial health insurance plans should automatically extend authorization period for those cases that were delayed. This will help the medical practices from an administrative standpoint so that they do not have to repeat the lengthy authorization process again.
Landlords Are Responding
Many private orthopaedic practices in Texas have reported that their landlords are forgoing or deferring their rent payments until the state allows all surgeries to move forward.
Medical Liability Insurance Relief
Texas Medical Liability Trust (TMLT), which is the largest medical liability insurance carrier for physicians in Texas, announced that it is helping physicians who are facing economic challenges during this time, including the decision to not process non-pay cancellations and allow extra allowances on extended leave or part time.
All medical liability carriers are asked to push back premium costs and spread them out over several months once the ban on all surgeries ends.
Many orthopaedic practices are working with their banks to help with the Small Business Administration (SBA) loans. Many are local banks that are ensuring that the practices will have access to the loans.
Many commercial health insurance companies have agreed to pay telemedicine visits at the same rates as contracted in-person rates, which allows patients to be seen by telemedicine.
The Texas Orthopaedic Association was founded in 1936 as a voluntary organization of Texas orthopaedic surgeons whose mission is to ensure outstanding musculoskeletal health for Texans. TOA represents over 1,400 Texas orthopaedic surgeons.