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Research ArticleOriginal Research

COVID-19's Financial Impact on Primary Care Clinicians and Practices

Melissa K. Filippi, Elisabeth Callen, Ann Wade, Megan Coffman, John M. Westfall, Yalda Jabbarpour, Christina M. Hester and Jennifer Carroll
The Journal of the American Board of Family Medicine May 2021, 34 (3) 489-497; DOI: https://doi.org/10.3122/jabfm.2021.03.200502
Melissa K. Filippi
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
PhD, MPH
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Elisabeth Callen
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
PhD, GStat
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Ann Wade
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
BS, BJ
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Megan Coffman
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
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John M. Westfall
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
MD
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Yalda Jabbarpour
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
MD
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Christina M. Hester
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
PhD, MPH
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Jennifer Carroll
From the American Academy of Family Physicians National Research Network, Leawood, KS (MKF, EC, AW, CMH, JC); Robert Graham Center for Policy Studies, Washington, DC (MC, JMW, YJ); Department of Family Medicine, University of Colorado, Aurora, CO (JC).
MD, MPH
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  • Article
  • Figures & Data
  • References
  • Info & Metrics
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Article Figures & Data

Figures

  • Tables
  • Figure 1.
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    Figure 1.

    Number of Times a Unique Participant Has Participated.

  • Figure 2.
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    Figure 2.

    Locations of Respondents (n = 268). Note: A total of 193 participants have missing locations.

Tables

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    Table 1.

    Respondents' Specialty and Practice Type Affiliation, (n = 461)

    n (%)
    Specialty
    Family medicine312 (67.7)
    Other20 (4.3)
    Behavioral health8 (1.7)
    General internal medicine7 (1.5)
    Emergency medicine4 (0.9)
    Dental1 (0.2)
    Missing109 (23.6)
    Practice Type
    Primary care only132 (28.6)
    Multi-specialty group (primary and specialty physicians)34 (7.4)
    Academic practice34 (7.4)
    Other28 (6.1)
    Academic center-based residency program26 (5.6)
    Community-based residency program25 (5.4)
    Integrated health23 (5.0)
    Federally Qualified Health Center (FQHC)21 (4.6)
    Rural health clinic20 (4.3)
    Affiliated with academic medical center19 (4.1)
    Community Health Center (CHC)10 (2.2)
    Fellowship program3 (0.7)
    FQHC Look-Alike (FQHC-LA)3 (0.7)
    • View popup
    Table 2.

    Weekly Survey Distribution Details

    Weekly SurveySurvey Distribution andClose Dates*Survey Respondents (N)Respondents Who Answered the Financial Impact Question (N)
    Week 1March 27 to 30186145
    Week 2April 3 to 611493
    Week 3April 10 to 13176131
    Week 4April 17 to 2012589
    Week 5April 24 to 2710181
    Week 6May 1 to 49679
    Week 7May 8 to 118065
    Week 8May 15 to 186858
    Week 9May 22 to 257566
    Week 10May 29 to June 18266
    Week 11June 5 to 86352
    Week 12June 12 to 156557
    Total1231†982†
    • ↵* Close dates in 2020.

    • ↵† Respondents include those that answered this question in multiple surveys.

    • View popup
    Table 3.

    Number of Responses by Categories Based on Weekly Results

    Week 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10Week 11Week 12
    Patient visits874561403838272835282423
    Financial strain261617112830373143433538
    Staffing232022332620221612191018
    Video (telehealth)45203324229985947
    Audio-only (telehealth)12476105131122
    • View popup
    Table 4.

    Staffing Tactics Used to Cut Costs

    Staffing Tactics Used to Cut Costs
    Reduce hours
    Reduce salary
    Implement layoffs
    Use furloughs for physicians, staff, and/or owners
    Allow employees to work part-time to qualify for unemployment depending on the state
    Redirect providers to inpatient care (or other areas where there could be more demand)
    See more patients per day to make up lost revenue, cross-train and transfer staff to areas that have high demand and need extra support (eg, inpatient care)
    Omit physician bonus and incentive pay, and not pay hazard pay
    Pause contributions to retirement benefits
    Keep mid-level professionals (less expensive than experienced staff)
    Incorporate hiring freezes
    Offer voluntary time off without pay
    Direct employees to use paid time off
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The Journal of the American Board of Family     Medicine: 34 (3)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 3
May/June 2020
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COVID-19's Financial Impact on Primary Care Clinicians and Practices
Melissa K. Filippi, Elisabeth Callen, Ann Wade, Megan Coffman, John M. Westfall, Yalda Jabbarpour, Christina M. Hester, Jennifer Carroll
The Journal of the American Board of Family Medicine May 2021, 34 (3) 489-497; DOI: 10.3122/jabfm.2021.03.200502

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COVID-19's Financial Impact on Primary Care Clinicians and Practices
Melissa K. Filippi, Elisabeth Callen, Ann Wade, Megan Coffman, John M. Westfall, Yalda Jabbarpour, Christina M. Hester, Jennifer Carroll
The Journal of the American Board of Family Medicine May 2021, 34 (3) 489-497; DOI: 10.3122/jabfm.2021.03.200502
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Keywords

  • Alternate Payment Model
  • COVID-19
  • Economic Impact
  • Family Physicians
  • Financial Impact
  • Pandemics
  • Patient Visits
  • Primary Care
  • Telehealth
  • Workforce

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