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Advocates want more relief for primary care physicians during pandemic

[Public domain], via Wikimedia Commons

Delaware health care payers and providers are trying to come up with solutions for primary care practices struggling during the coronavirus pandemic.

The advocacy group Delaware Academy of Family Physicians says primary care practices in the First State have seen a 50% average drop in patient volume since March 12th when Gov. John Carney declared his State of Emergency Order.

The group’s Executive Director Ray Saputelli is calling on all health care payers in Delaware to offer advance payments for primary care practices to avoid staff layoffs as physicians work to keep their patients healthy and out of the emergency room during the pandemic.

“So look at the patients they’re going to care for and pay for those patients on a prospective basis—especially now to help those practices with cash shortfalls,” said Saputelli.    

The federal Centers for Medicare and Medicaid Services (CMS) has taken this step, as have some private insurers in Delaware. 

Highmark Blue Cross Blue Shield Delaware CEO Nick Moriello says Highmark has begun forwarding payments that were scheduled for June to physicians participating in the company’s value-based program called True Performance.

“We’re advancing all of their payments effective immediately,” said Moriello. “So we’re trying to help those practices that may be experiencing cash flow problems themselves as businesses, and in some instances small independent businesses.”    

Moriello says Highmark is offering more than $1.9 million in advance payments to 59 First State providers.

Delaware Insurance Commissioner Trinidad Navarro says he would support a similar plan on the state level.

“I will say that we’re working on it. I will say that I support it,” said Navarro. “It doesn’t happen overnight, but it’s something that has been on our radar for some time.”

But Saputelli says more is needed for practices still being paid based on the fee-for-service model rather than value-based care. Under fee-for-service, physicians bill payers for visits, tests and services. Value-based models allow physicians to share in the savings when patients have healthy outcomes and are less costly to care for.

“This crisis really has exposed for us that the fee for service system puts physicians in a really bad position,” said Saputelli. “Especially small independent primary care practices who tend to be the backbone of their communities.”

During the pandemic many physicians are switching to telehealth visits with patients as a social distancing measure. Gov. Carney’s Emergency Order eases up restrictions on those visits.

Seputelli says most payers are offering the same compensation for physicians for telehealth visits as regular visits. But he notes even those who successfully transitioned to the virtual platform are still seeing a 25% - 30% decrease in patient volume.

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