Can PCPs Survive COVID-19? Only If Fee-for-Service Goes

Primary care practices need new ways of being paid if they are going to survive and thrive in the wake of the COVID-19 pandemic, several speakers said last week during a webinar hosted by the Alliance for Health Policy. “Fee-for-service is simply not a system this is conducive or amendable to primary care being able to thrive and meet all of its opportunities and needs even in a normal day, and certainly not in a COVID day,” Asaf Bitton, MD, executive director of Ariadne Labs in Boston, said on the webinar, which also was sponsored by the Commonwealth Fund and the National Institute for Health Care Management. “When visits get disrupted for any reason … and combine that with the fact that the majority of primary care practices have low reserves or no reserves — they often exist on a month-to-month basis and don’t have that prospective form of predictable population-based payment — that really puts them at risk of not being able to make it through this tumultuousness.” Prior to the pandemic, a solution was being developed to this problem — physician-based accountable care organizations (ACOs), said Sean Cavanaugh, MPH, chief administrative officer at Aledade, a company that helps practices set up ACOs.

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