Health care providers under pressure with fewer appointments, low telehealth reimbursements

COVID-19 pandemic impacts health care providers

MONTGOMERY, Ala. (WSFA) - Across the state, physician waiting rooms are mostly empty. It's a far different scene than three weeks ago when patient demand overwhelmed most offices.

Montgomery Women’s Health Associates promptly made the decision to narrowly limit in-office visits to protect patients and obstetricians who care for expectant mothers.

“We made the decision on Friday 13 about what business would look like moving forward because the safety and health of our patients is our number one priority,” stated Katie Carter, a Certified Registered Nurse Practitioner.

Her office has gone from seeing upwards of 200 patients a day to around 100 a week, most through telehealth technology.

“Just because there is a pandemic it doesn’t mean that there aren’t other health care issues that have to be addressed,” she explained. “That’s why we are here, because we do want to take care of our patients, whether that be in person or via telehealth, but we want it to be in a safe manner.”

Telehealth calls reimburse at one-third the rate of general office visits. Much like all small businesses, Carter’s practice is feeling the strain.

“Our providers here at our office have made some sacrifices from a business standpoint so that we can keep all of our employees,” said Carter. “We’re a family here at Montgomery Women’s Health, we don’t want any of our employees or staff to question if they have a job tomorrow.”

Dr. Lee Carter, no relation, operates a family medical practice in Autauga County. He shares the same concerns.

“You know for us and all practitioners, my friends I’ve spoken with on the phone, our inpatient offices have been cut or diminished at least 50 percent,” Dr. Carter explained.

Carter is dedicating the first half of his day to seeing patients in clinic, either in house or even in the parking lot, and using the remainder of the day for telehealth.

“This is more adapt and overcome and do what you’ve got to do to keep the doors open, keep your employees paid, and try and keep folks healthy,” he said.

During the pandemic, Medicare is reimbursing doctors the full cost of an office visit for those who utilize telehealth, all in an effort to avoid contact with seniors who are among the most vulnerable population. If private insurers adopt the same practice, both providers say it would improve their financial outlook.

“Hopefully, some of the commercial insurance payers are going to do the same thing and try and help us out as we try to help people stay on their regular medications and help coordinate for the local and state health department with coronavirus testing,” stated Dr. Carter, also citing that without offices like his more people would be forced to go to the hospital for general care.

Montgomery Women’s Health Associates remains full-staffed, and Dr. Carter’s office is nearly full-staffed as some alternate working afternoons.

“It helps right now because some have children who need to be taking class at home and they can see after that,” Carter said.

Despite the low reimbursement rate, Katie Carter says her office will continue to see patients, stating the practice's fiscal outlook pales in comparison to her patients' physical wellbeing.

“We do want to still be here when this settles down and we are hopeful and prayerful that business will return to normal if not busier than ever before,” she said. “Again, we’re never going to compromise our patients’ health for our own benefit. So far our patients have been wonderful as far as appreciating and understanding the different safety precautions that we have implemented in this practice.”

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