Practice Management Challenges of Covid-19

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The COVID-19 pandemic is confronting medical practices with unique operational challenges. Some practices have turned to telemedicine. Some providers are finding it difficult to continue operating at all, with sweeping cancellations of elective procedures and discouragement of in-person office appointments. Economic fallout due to the virus’s effects on virtually every person, everywhere, is another concern facing all aspects of all healthcare systems.

The American Medical Association has issued guidelines for managing the financial and operational consequences of the outbreak. The following matters should be considered.

Business Insurance

Ensure the practice’s business insurance covers COVID-19 related liabilities. This helps determine associated risks and is important in making business and operational decisions. Contact the practice’s insurance brokers for complete copies of all policies. Understand government emergency decrees. Track losses and expenses incurred for future claims. Consult legal counsel about exercising existing policies and how state government orders affect business operations. Providers who are called upon to assist with emergency care, especially outside of their usual clinical arrangements, should notify their liability carrier(s). Contact the U.S. Department of Health and Human Services for their published declaration of liability protection against certain medical countermeasures related to COVID-19.

Financial Obligations and Contingency Planning

To minimize potential economic risk, practices are encouraged to revise current financial plans to ensure their ongoing liquidity. It may protect a practice from revenue loss due to cancelled procedures, fewer outpatient visits, and closures. It is wise to develop a financial contingency plan based on minimum cash flows needed to continue operation. Examine existing loan documents and financial obligations to determine risk of default if revenue is being lost. Managing cash well is high priority; consider delaying payments of discretionary bonuses. Determine if you may request forbearance or forgiveness from lenders and creditors. Communicate with third parties before crisis occurs, which may increase the probability that your requests will be granted.

Monitor resources that may become available to you, such as economic relief packages. The U.S. Small Business Administration has introduced low interest loans.

Supplies

There are global shortages of essential medical supplies, such as personal protective equipment. Evaluate current supplies, and project future needs. A decrease in office visits may decrease the practice’s supply needs. Determine how much cash can be devoted to stocking up on essentials. Contact vendors to ensure that you are listed among businesses to receive future supplies.

Continuing Business Operations

“Shelter in place” orders and their extensions may affect the ability to continue business operations. Healthcare services are usually designated as essential businesses, but the public may be unclear about the availability or safety of their usual services. Consult local counsel to determine how to apply executive orders affecting a practice.

Communication with Patients

Whether a practice is operating normally or offering telehealth services, it is essential to regularly communicate with patients – especially those at risk of adverse health consequences if their healthcare is interrupted. There is an increasing number of patients neglecting usual medical care because they fear contracting the virus in hospitals or medical facilities. Make your patients aware of the prevention and safety measures enforced at healthcare sites. They should be encouraged to maintain contact with their providers, via telehealth or in person when needed.

Workflow

To protect staff members, conserve valuable equipment and supplies, and reduce the safety and liability risk to your practice, providers are urged to follow the latest guidance issued by governmental agencies when reviewing scheduled visits and choosing which appointments to postpone, cancel, or proceed with as usual.

Employee Management

Keep employees informed about managing health and safety issues. Outline when they should not report to work. Specify leave policies. If it is necessary to furlough or terminate non-essential employees, seek legal counsel on business obligations and communication of employment status.

The pandemic has created unprecedented policy and regulatory changes. It is essential for healthcare providers to stay current. As the COVID-19 outbreak evolves, more federal guidance and relief efforts are expected to offer further support.

The CDC has issued interim guidance for management of health services: COVID-19 Guidance: Businesses and Employers | CDC.

The U.S. Department of Labor has also published resources pertaining to employee furloughs and unemployment benefits as well as Guidance on Unemployment Insurance Flexibilities During COVID-19 Outbreak.