April 16, 2020

Protecting Primary Care in California During COVID-19 Pandemic

The Pacific Business Group on Health, as part of a coalition of physicians, consumer and business leaders, is calling on California state legislators to protect the very foundation of our health care system by supporting independent primary care providers vulnerable to the huge economic impacts of the COVID-19 pandemic.

Primary care physicians in California and across the nation are facing unprecedented threats to the survival of their practices and their ability to adequately serve their communities. One-third of primary care physicians in California are worried their practices and clinics will be forced to close because of the financial consequences of the COVID-19 pandemic and the significant drop-off in non-COVID medical visits. Many have already furloughed or laid off staff or reduced physician pay, even while dramatically increasing phone and video visits with patients, according to a recent report by the California Health Care Foundation . Independent primary care practices receive relatively low compensation in comparison to other specialties and, as a result, do not have the financial reserves to weather the current crisis.
If we don’t support primary care practices, they’ll either close or be bought up by larger health care systems or private equity groups. We know from historical evidence that this will drive market consolidation and increase costs without any increase in quality or improvement in patient experience.

COVID-19 has shown the critical link between our physical and economic health. Hospitals are already overburdened and people need to be able to get care in their communities from a primary care doctor. Once we lose these frontline health care workers, the damage will be impossible to undo. We need primary care physicians to remain independent.

That’s why PBGH, in partnership with the California Medical Association, which represents the interests of California’s physicians, and others, is asking legislators to support the Care for Californians Initiative , a proposal that calls on health insurance companies to use unspent premiums already collected from employers and consumers to pay primary care providers emergency prospective payments for 2020 and 2021. Some health plans are already leading on this issue.

These prospective payments would serve as a lifeline to these providers and would maintain the requirements on plans to reimburse virtual and telehealth visits at the same rate as in-person services.  In addition, the Care for Californians Initiative would establish a process to adopt new payment models that foster resilience and support primary care as a central element of the movement toward patient-centered care that delivers better value.

Large Employers are Worried About Losing Primary Care

PBGH members – large private employers and public purchasers of health care – understand that primary care is the backbone of a highly functioning health care system and key to reducing the total cost of health care by ensuring people get the right treatment at the right time. In a recent poll of our own members, 90% say they want a strong primary care delivery system in which doctors are rewarded for helping their patients stay healthy at an affordable cost; one that integrates with mental health for more holistic patient care and excels at managing the chronic diseases affecting so many Americans.

They also understand that our physical health is intimately linked with our economic health. Primary care is central to improving both.

Now is the time to use all the tools at our disposal to ensure our health care system remains intact during the immediate crisis and for the long term. We must think about what we want our health care system to be after the worst of this pandemic will leave behind.

By using unspent premiums collected by health plans to provide for emergency prospective payments for primary care physicians, the Care for Californians Initiative will help Californians maintain essential access to the care they need now and into the future.