In late March, the NC Pediatric Society teamed up with the NC Academy of Family Physicians to conduct a survey of more than 750 primary care physicians to help determine how pediatricians and family medicine doctors are handling the unique challenges presented by COVID-19, NCPeds and NCAFP are now using the survey findings to advocate for supports primary care, such as the recently announced doubling of the Medicaid per member per month payment to practices.
Key Findings and Silver Linings
Key findings indicate that the overwhelming majority of primary care physicians are now under “significant” or “extreme” financial distress and are having to cut hours, salaries, and workforce in an effort to stay solvent . NCPeds and NCAFP used the survey results to advocate for members’ needs in a joint letter to NCDHHS.
Thankfully, state officials wasted little time in responding. As of April 16, Medicaid’s Per Member Per Month (PMPM) began to double to help practices cope with the COVID-19 crisis. This translates to more than $2.5 million in additional funding to medical homes caring for children that will be paid every month until the crisis is over. This change is an addition to the roughly 25 percent increase in Medicaid rates NCPeds and NCAFP helped to secure in 2019. Working together with NCAFP plus AHEC, CCNC and the NC Psychiatric Association we’ve hosted webinars on federal and other fiscal relief avenues for practices.
Concerns about Personal Protective Equipment (PPE)
In the survey, respondents report that access to appropriate PPE remains a concern. Seventy-six percent of respondents reported problems in obtaining appropriate PPE; this figure increases to 89 percent for physician-owned practices. Together with the NC Medical Society, NCPeds and NCAFP urged stateofficials to procure the needed equipment rapidly to fulfill the current day-to-day needs of practices as well as in anticipation of a surge in COVID-19 cases that could overwhelm hospital capacity. NCDHHS recently announced a statewide website to marshal requests for PPE. Special tips and resources have been shared via the practice manager listserv and regular emails from the Executive Director.
Fully 95 percent of pediatricians surveyed said they were making the pivot to telehealth.To help with the transition, Medicaid and most other insurance providers are paying telehealth codes at parity with in-person visits and providing enhanced rates for telephonic codes.
As a corollary, a majority of physicians said they needed help with educating parents and caregivers about the availability of new telehealth options. NCPeds and NCAFP responded to this need by creating a social media toolkit for members. The kit includes customizable graphics for practices to use on Twitter, Facebook, and Instagram and is available to NCPeds members here. NCPeds is also promoting well-child guidance from AAP that prioritizes in-person visits for children under age 2, noting especially the need to keep vaccination rates strong.
Solution Share Calls and Member Help
NCPeds is here for you! We’re dedicated to ensuring that you have the most up-to-date information and resources for weathering the COVID-19 crisis. NCPeds will continue to host our weekly Solution Share calls every Tuesday at 5:30 p.m. for as long as needed. However, you must be a member to register for these calls. Please register for each Solution Share Zoom call here.
Please continue to check our COVID-19 Resources and Updates page for the latest information on telehealth and other resources available to you and your practice. Current updates are shared via regular emails. For members who are good with a very large volume of emails, the Practice Manager listserv is a great resource for troubleshooting.
If you are not connected with any of these resources and would like to be – or need other supports – please let us know. We will be sending out another survey in the near future. Please know that your response drives our work and advocacy. We appreciate all you are doing to keep children safe and healthy!