BC Advantage - 2020 Issue 5
Physician Reimbursement: COVID-19 Demonstrates the Need for Independent Physician Groups to Assert Their Authority Against Payers
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Article Overview
This article discusses physician reimbursement in the context of COVID-19, focusing on telehealth coverage, payer contracting, and the changing leverage of independent physician groups. It is written for physicians, practice leaders, and revenue-cycle or contracting professionals who want a broad view of how the pandemic influenced reimbursement expectations and care setting decisions. The piece addresses general themes such as telehealth policy shifts, outpatient care, contract negotiation, and the financial pressures faced by medical practices.
Why This Topic Matters
It explains why the pandemic changed long-standing assumptions about reimbursement and contracting, and why independent practices may need to revisit payer relationships and payment terms.
Article Sections
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Telehealth and payer coverage before and during COVID-19
The article opens with a discussion of telehealth access, payer resistance, and the rapid changes that occurred during the public health emergency. It also touches on how utilization patterns and convenience affected adoption.
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How COVID-19 is changing reimbursement
This section describes broader shifts in physician reimbursement, hospital roles, and the movement of care to outpatient settings. It frames the pandemic as a catalyst for rethinking contracting relationships.
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COVID-19 should change the way we look at reimbursement
The article outlines the financial strain practices experienced during the pandemic and discusses the need to reassess payment structures. It emphasizes the effect of reduced visit volume and operating pressures on practice stability.
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What physicians can do
This section focuses on general contracting and negotiation themes for practices responding to changing reimbursement conditions. It presents the article’s practical call for reevaluating payer agreements.
What You Will Learn
- How the COVID-19 era affected telehealth coverage and access
- Why payer contracting became a larger issue during the pandemic
- How reimbursement pressures can affect physician practice operations
- What broad areas practices may consider when revisiting payer relationships
Who Should Read This
- Physicians
- Independent physician groups
- Practice administrators
- Revenue cycle professionals
- Healthcare contracting professionals
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