Robin Gelburd President, FAIR Health

Health Care Professionals Suffer Drastic Drop in Revenue From COVID-19 Epidemic Interview with:

Robin Gelburd President, FAIR Health

Robin Gelburd

Robin Gelburd
President, FAIR Health What is the background for this study?

Response: As a result of the COVID-19 pandemic, healthcare professionals have been under prolonged stress, including the financial stress of widespread deferral of elective procedures. To investigate the pandemic’s impact on professionals’ utilization and revenue, FAIR Health analyzed data from its database of over 31 billion private healthcare claim records, the nation’s largest such repository, which is growing by over 2 billion claim records per year. What are the main findings? 

Response: The study found that nationally, from March 2019 to March 2020, utilization of professional services decreased 65 percent and professional revenue based on total estimated allowed amounts decreased 45 percent. From April 2019 to April 2020, utilization fell 68 percent and revenue 48 percent. FAIR Health compared the changes nationwide to those in the Northeast, where the pandemic hit hardest in March and April. In the Northeast, from March 2019 to March 2020, utilization of professional services fell 60 percent and revenue based on total estimated allowed amounts declined 55 percent. In April, utilization fell 80 percent and revenue 79 percent. What areas of medicine are most severely impacted?  Do you expect recovery in most areas or will  some practices have to fold or be forced to join larger health care systems?

Response: The study focused specifically on seven specialties: cardiology, dermatology, oral surgery, gastroenterology, orthopedics, pediatric primary care and adult primary care. Of the specialties studied, oral surgery had the largest decreases in March 2020 utilization (80 percent), March 2020 revenue based on total estimated allowed amounts (84 percent), April 2020 utilization (81 percent) and April 2020 revenue (92 percent). Gastroenterology had the second largest decreases in all four categories.

FAIR Health does not take a position with respect to the future of healthcare practices. We present revenue and utilization data on healthcare professionals in the hope of stimulating further research and policy making in this area. What should readers take away from your report? 

Response: This study found that, from March-April 2019 to March-April 2020, utilization of professional services decreased, as did professional revenue based on total estimated allowed amounts. Nationally and in the Northeast, the decreases were comparable in March, but in April the decreases in the Northeast were notably greater than nationally.

The seven specialties studied all experienced declines in utilization and revenue based on total estimated allowed amounts from March-April 2019 to March-April 2020, but the declines varied considerably. Oral surgery and gastroenterology had the first and second largest decreases, respectively. Pediatric primary care had the smallest decreases.

Across many specialties from January to April 2020, office or other outpatient E&M visits became more common relative to other procedures, both by utilization and total estimated allowed amounts. This may have been due in part to the fact that many of these E&M services could be rendered via telehealth, whereas certain other procedures that became less common required in-person visits.

Decreases in preventive care varied by age of patient. There was little change from March-April 2019 to March-April 2020 in preventive care visits for pediatric patients 0-4 years of age, whether from the standpoint of utilization or of revenue based on total estimated allowed amounts. Decreases in these months were much greater for preventive care visits for older pediatric patients (5-17 years of age) and adults (18 and older). What recommendations do you have for future research as a result of this work? 

Response: FAIR Health plans next to research the impact of the COVID-19 pandemic on dental practices. We encourage other researchers to use the data in our series of COVID-19 studies as the basis for their own research.

Any disclosures? FAIR Health is a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health qualifies as a public charity under section 501(c)(3) of the tax code. 


Published on: June 11, 2020

Health Care Professionals and the Impact of COVID-19: A Comparative Study of Revenue and Utilization
AJMC June 11 2020 


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Last Modified: Jun 11, 2020 @ 11:38 pm 

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