Coronavirus: 14 tips to keep your private practice in business

Implement a practice for rapid decision-making and planning

·      Create a clear chain of command and rapid response process

·      Tell your employees that your response team is evaluating the situation daily and that the highest priority is patient and staff safety

·      Think ahead about possible issues before they arise

Understand your insurance coverage

·      Insurance policies may not cover you or your employees for COVID-19 liabilities

·      Figure out what your risk is by contacting your insurance broker

·      Look at actual government emergency orders and decrees

·      Tack expenses and losses for future insurance claims

·      Speak to legal counsel about your options

Evaluate ongoing financial obligations

·      Rethink financial plans to maintain cash-on-hand should practice revenue drop off

·      Create a contingency plan based on estimates of minimum cashflow needed

·      Review your loans to see if a drop in business can force a default

·      Proactively speak with vendors, landlords, and creditors to discuss possible accommodations

Make a financial contingency plan

·      Manage cash the best as you can and consider delaying bonuses or other discretionary payments

·      Consider asking lenders for forbearances, forgiveness, or a standstill and keep them informed throughout the pandemic

·      Monitor available from economic relief packages

·      Reach out to the U.S. Small Business Administration and other organizations like the United Way about programs they offer

Assess current and future supply needs

·      Take stock of what supplies your practice has on hand and what money will be needed to stock up

·      You may be called upon to triage patients for other facilities so make sure your practice is in the queue to receive necessary supplies by contacting vendors and public health officials

Understand how to continue business operations

·      Many shelter in place orders designate medical practices as essential operations or critical infrastructure but other businesses that affect your practice may be effected

·      Consult with local legal counsel early about the orders

·      The AMA has provided two template letters which can be used in conjunction with legal counsel

Consolidate administrative resources, coding tools

·      Office administrators should compile a quick guide of essential resources for meeting immediate needs

·      Physicians and staff will likely need to adhere to record keeping practices outlined in the standard of care

·      Consider and implement a way to maintain documentation during a shutdown to obtain payment

Manage workflow

·      Check CMS recommendations to delay adult elective surgeries and non-emergency medical procedures and use those recommendations to decide whether to reschedule or cancel visits

Utilize digital health tools

·      Inform your staff and patients about the use and availability of these tools

·      The AMA has produced a quick guide to telemedicine practice which can give guidance on using the service

·      The Federation of State Medical Boards tracks state emergency declarations and licensing orders

Communicate guidelines for employees

·      Institute guidelines to help staff make the best health decisions for themselves and their families

·      The CDC has produced interim guidance on this topic

·      The federal and some states have implemented COVID-19 related leave and benefits for employees

Plan ahead for employee furloughs

·      Consult with appropriate legal counsel on your practice’s obligations in case a furlough is necessary

·      Identify workflow changes that may be required

·      Communicate with your local healthcare systems and authorities about external opportunities for furloughed or terminated staff

Stay abreast of new care delivery flexibilities

·      The federal government and some states are waiving regulatory hurdles to care on a daily basis

·      Task one staff member with informing the practice of changes brought by these waivers

·      Legal and financial obligations may change due to these actions

Prepare for exposure incidents

·      Follow CDC guidelines on infection prevention and control

·      See if any engineering or administrative controls can limit possible exposure to infection

Identify and implement COVID-19 specific clinical protocols

·      Establish a plan for evaluating symptomatic patients, triage, surveillance, infection control, and isolation practices

·      Plan for communication with and reporting to public health authorities

·      Be aware of facility access and security