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Dr. Bart Bruns

Courtesy photo

The current health crisis is so dramatically different from anything we have experienced before, from the way we live our lives to the way businesses operate to the way health care is delivered.

For starters, the crisis has hit the health care sector as hard as everywhere else. It may seem counterintuitive that the medical field would be vulnerable to an economic slowdown during a global pandemic, but from an operations standpoint, local health providers are just small businesses. They rely on patient appointments to keep their doors open.

While hospitals prepare for the worst-case scenarios, local providers have seen a dramatic decline in non-emergency patients, from regular checkups to specialist visits to routine surgery. Most are down by half, and some as much as 80% — not sustainable for any business or employer.

These are essential businesses, health crisis or not, and they have the same concerns about cash flow, making rent, and meeting payroll.

It is important to remember that a medical provider isn’t just a doctor or physician’s assistant. Each practice requires a support staff made up of nurses, receptionists, medical assistants, and others who ensure the delivery of medical care.

Just like the restaurants, salons, and retail stores that have had to quickly change their service and product delivery methods, medical providers are looking for ways to meet their patients’ needs as people are staying home. Additional precautions are taken to ensure patients are screened when they come in for a checkup. Telehealth is a major component as well, with many appointments being handled remotely.

This issue is even more pronounced in rural areas where it is already difficult to recruit and retain skilled providers. Adding financial insecurity into the equation is likely to lead to more of these health professionals pulling up stakes and moving elsewhere.

Part of the glue that keeps this medical community together is Umpqua Health Alliance, the coordinated care organization (CCO) that connects and supports providers who work with members on the Oregon Health Plan – about 30% of all Douglas County residents. UHA has supported local nonprofits working to meet basic needs in the community, assisted providers in building their menu of telehealth options, and helped staff the public health crisis hotline.

But along with operational support, UHA has stepped in to give early payment to providers who are struggling financially. Umpqua Health typically withholds a portion of the provider payments from OHP until a financial audit has been performed and reimburses for care after it has been provided. UHA has approved a cash advance to providers who have seen a decline in their practices, helping cover the cost of service in the months to come. These providers will also receive the withheld funds before the financial audit is complete.

The goal, much like flattening the infection curve of COVID-19, is to decrease the financial burden on health providers through the early stages of this crisis. And yes, these are still the early phases. Businesses of all kinds have a long road ahead to rebuild their income and customer base, and medical care is no different.

But like all essential businesses, the need for health care will remain strong. These early payments are a lifeline for a provider to keep their staff paid while continuing to offer care to those who cannot wait for the stay at home orders to be lifted.

We’ll need these providers to be at full strength as things begin to return to normal, as postponed appointments are rescheduled, and deferred care becomes critical. We need a healthy health care sector to create a healthier Douglas County.

Dr. Bart Bruns, M.D., is a Roseburg anesthesiologist, the CEO of Douglas County Independent Physicians Association, and the Chair of the Umpqua Health Alliance Board of Directors.

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