The Provider Insurance Revenue Study in Healthcare Providers in the United States of America

Since the beginning of the COVID-19 pandemic in March, 2020, Physicians and other medical
Providers have taken devastating hits to their practice revenues. Most of the losses are
due to doctors being forced to curtail elective procedures and office visits as Americans
were ordered to stay home during the height of the national health emergency.

As Physicians were able to return to work in the early Summer, even if only partially,
many had to adjust to the newer medical practice of telehealth, and the lower revenues
that came with it. The Centers for Medicare & Medicaid Services (CMS) gave assurances to
Physicians that Medicare would reimburse telehealth encounters at 100% of the office
visit rate. But private Payers were under no such obligation. Across the country,
Physicians are reporting that they're being reimbursed at about 70% of an office visit
rate despite the fact that telehealth requires both resources and expertise to implement
effectively, and each encounter takes up to twice as long as an office visit.

Adding to financial hardships, Physicians across the nation are reporting that legitimate
insurance claims are being held up and denied by the insurance companies at a higher rate
than ever, cutting off the cash that they need so desperately. As of June 1, only half of
Physician practices say they have enough cash to stay open for another month.

In just 2 months in the spring of 2020, over 45 million Americans lost their jobs and for
many, that also meant the loss of their employment-related health insurance. Despite
shedding a massive number of members from their rolls, health insurance companies are
actually predicting record profits for 2020. The pandemic it seems, is very good indeed
for the health insurance business. Private investors and executives are taking huge
dividends and bonuses out of the system just at a time when US healthcare needs a vast
new investment of healthcare resources into the system. The good fortune of a few
individuals and corporations comes at an as yet untold expense to American society.

The formula for insurance company success in a pandemic only happens one way. By keeping
member premiums, delaying payments, and denying treatment authorizations, the large
health insurance companies are taking advantage of the profound misfortunes of both
doctors and patients during a national health emergency.

The COVID-19 pandemic will have adverse effects on the health of Americans that will be
sprawling and long-felt. However, it is not for this study to decide whether private
interests will always be antithetical to public interests when it comes to healthcare.
That is a public debate that will continue to evolve as the profound weaknesses of the
American way of distributing healthcare are magnified and exposed in a time of social
upheaval.

The investigators do know that in order to get a handle on the major damage we see
occurring in real-time- and to inform that debate, it is first necessary to measure it.