AAFP, Others Warn Azar of Imminent Primary Care Closures

"Patients and communities, especially those that are underserved and under siege because of COVID-19, cannot afford widespread closures of community-based primary care practices," warned the Academy and other health care organizations in a May 19 letter to HHS Secretary Alex Azar.

"Our organizations strongly encourage you to provide additional funding to independent and community-based primary care practices, including Medicaid providers," added the letter.

The Academy's six co-signatories were the Alliance to Fight for Health Care, the American Academy of Pediatrics, the American Benefits Council, the American College of Physicians, America's Health Insurance Plans and the Blue Cross Blue Shield Association.

"Community-based primary care is the foundation for ensuring our health care system delivers accessible, high-quality, affordable care," the groups said. But the pandemic has cracked open that foundation, with some 70% of primary care practices reporting 50% or greater declines in patient volume since the public health emergency began.

That figure, from a May 6 Primary Care Collaborative report, is eye-catching but well within the context of other numbers in that organization's increasingly grim weekly surveys of primary care clinicians. The letter to Azar cited the same report to caution that 38% of respondents said they expected to see an increase in non-COVID deaths because of delayed or forgone care.

Thirty-five percent of respondents said they expected most independent primary care practices not to be in operation after this first COVID-19 wave.

The letter agreed that this was "increasingly a likely consequence as primary care practices lose revenue and are not able or eligible to access much of the federal emergency funding." Practices that care for Medicaid enrollees but do not participate in Medicare, for example, have been excluded from the Provider Relief Fund's general allotment.

Available remaining funding, along with any new federal support, must therefore flow to independent and community-based primary care clinicians in need, the groups said.

Primary care physicians continue to work on the front line of the pandemic, screening and treating patients and standing with surge personnel in ERs and overwhelmed inpatient units, the letter added. They also must go on providing comprehensive care to their existing patients, now and after the emergency.

"These two roles are critically important to individual patients, hardworking families and all of our communities but, more important, they are essential to our national efforts to defeat and overcome the COVID-19 crisis," the AAFP and its co-signatories said. "That is why it is so important that community-based primary care physicians immediately access emergency federal support."