PROVINCETOWN — No clinical services to patients have been canceled since Outer Cape Health Services last week furloughed or laid off nearly half its staff because of lost revenue caused by the coronavirus pandemic.
Federally qualified health centers like OCHS are the “canaries in the coal mine” of the economic crisis caused by COVID-19, according to the Mass. League of Community Health Centers. Though it was not clear whether any other such centers in Massachusetts had announced staff reductions as of Monday, Atrius Health, the largest independent health care organization in the state, also made temporary cuts affecting about half its workforce on March 23.
In a conference call on Monday, Dr. Andrew Jorgensen, medical director of OCHS, said no clinicians have been furloughed or laid off. But many support staff at all three clinics, in Provincetown, Wellfleet, and Harwich, will be out of work, mostly temporarily, for an estimated four to six weeks, said CEO Pat Nadle.
“Today has truly been one of the hardest days in my entire career,” Nadle stated on March 25. “Making decisions that impact even one staff member’s life is very difficult.”
OCHS has furloughed about 70 of its 200 employees. They can return to their jobs when patient visits and revenues return to normal. In the meantime they can apply for unemployment benefits and health insurance through MassHealth, Nadle said. Others, including members of the management team, will work reduced hours, she said. There will be a small number of permanent layoffs — “enough to count on one hand,” she said.
Gynecology, behavioral health, radiology, and other services will continue for now, Nadle said. Dentistry and ophthalmology were suspended about two weeks ago at the recommendation of the governor, Nadle said.
Cape Cod Healthcare, which operates both Cape hospitals, had avoided staff reductions as of the Independent’s deadline. But in reaction to the lost revenue from canceled elective surgery, CEO Mike Lauf announced he would give up his salary for April ($78,000 according to the Cape Cod Times). The trustees of Cape Cod Healthcare said they would match that amount in a donation to the company’s foundation.
At Outer Cape Health, the reduction in patient visits is expected to create losses of $1 million a month, according to Nadle’s announcement.
The League of Community Health Centers announced on March 20 that clinics like OCHS (which get federal funding to serve poor and rural areas) are expected to see revenue drop by 50 to 70 percent during the pandemic.
Ironically, health care is taking a hit because, as people isolate, they postpone seeing their doctors. Community health clinic revenue comes mostly from patient visits. For hospitals, the top revenue streams are from elective surgery and cardiovascular surgery, followed by cardiology, neurosurgery, orthopedic surgery, and gastroenterology.
In order to adapt to the losses, OCHS is applying for grants, and should benefit from the recent federal stimulus bill, though Nadle said the amount of help was still not known.
Aside from the aid package, the government is beginning to help shift the immediate revenue picture. The federal government did recently allow Medicare to begin paying for telemedicine appointments. Private and state-funded insurance companies were ordered by Gov. Charlie Baker to reimburse immediately for telemedicine, Jorgensen said. But that did not happen quickly on the federal level.
Telemedicine, which now accounts for about 80 percent of appointments, could help stop the spread of the virus, and saves on personal protective equipment, which continues to be in short supply.
